Hello all.
Vitex is good herb to use with lactation moms have used it for both
increasing and decreasing milk supply. Vitex, or chaste tree berry
somedtimes people call it monk's pepper. works on the pituitary and the
hypothalmus by regulation hormones prolactin estrogen and progesterone. It
helps to do a great balancing act. it also will help moms with PMS symptoms
and it does increase milk supply in those who need it for that. Many women
and herbalists will combine this with milk thistle to increase supply and
develop some glandular tissue. Milk thistle will add bulk to help pp women
soften stools and helps protect and detox ify the liver of all those drugs
used in labor. Milk thistle also bis traditionally used to build milk
supplies.
for the bf women it also has the benefit of normalizing vaginal secretions
and increasing libido- which some women find hard to increase while
breastfeeding.
I
According to newer studies it is safe to use in preganncy and lactation and
even long term.
Working with herbs many women like this and as a personal note i used it
while nursing my last two.
ps since it is a balancer it may for some women be an emmenagogue (bring on
periods). most find though it seem to normalize them. it is also great for
hot flashes in monopausal women.
normal dose is 3ml of tincture 3x daily or 450 mg caps 2 caps 2-3 times
daily.
also if you need it see my web page.
mechell turner,
www.birthandbreastfeeding.com
-----Original Message-----
From: Automatic digest processor <[log in to unmask]>
To: Recipients of LACTNET digests <[log in to unmask]>
Date: Monday, January 03, 2000 2:32 AM
Subject: LACTNET Digest - 2 Jan 2000 (#2000-6)
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Date: Mon, 3 Jan 2000 09:45:51 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: "Karen Kerkhoff Gromada, MSN, RN, IBCLC" <[log in to unmask]>
Subject: Re: mechanics of milk expression
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In a message dated 00-01-01 10:19:29 EST, you write:
<< Just for those who may never have handled a fit problem before, my protocol
involves generous feeding of the babies however parents desire. In this
case, with twins, the parents opted for bottles. These twins are to spend a
lot of skin-to-skin time with mom cuddling and nuzzling to keep rule 3
happening. As babies grow, they should transition nicely. Mom has been
given lots of positive suggestion about how "none of this is a big deal so
long as you keep pumping like crazy, along with some manual expression." >>
May I add that in all cases I think the "as parents desire" approach is best,
but the glitches in any approach are magnified when multiples are involved.
(This approach is promoted in ch. 13 of the Mothering Multiples 1999
revision, although alternatives are not covered in detail.) However, I'd
highly recommend finding out who is available to help with any alternative
feeds that don't include an "at breast" component.
If the mom is the one responsible for handling all or most alternative feeds
for one or more newborn multiples, plus pumping, plus getting in extra skin
contact with any that aren't breastfeeding, even if the other(s) can
breastfeed, it often means that something is going to go before too long into
the plan. Since rule # 1 is "feed the baby," rule # 2 "move the milk" and/or
rule # 3 "keep each breastfeeding couple intact" often are compromised.
Having someone relieve Mom of alternative feeds, so she can concentrate on
pumping and the skin contact can make a HUGE difference to a mother of
multiples. (And it works if the infant is a singleton too!)
Karen G.
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Date: Mon, 3 Jan 2000 09:00:59 -0700
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Tami Karnes <[log in to unmask]>
Subject: Vitex angus castus
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Vitex angus castus otherwise known as Chaste Tree Berry, has been used
successfully in women who suffer from a hormonal imbalance which is causing
their struggle with adequate supply. Since Vitex does have a direct effect
on hormone levels by attempting to bring all levels back to a state of
balance, it is not an herb that a recommend in very many cases. Generally,
a hormone panel should be performed prior to using this herb for the
increase of supply to discover the source of the imbalance (if any). Often
times, moms that struggle with supply we will recommend Fenugreek and/or
Blessed Thistle before using something like Vitex.
If you have direct questions about the use of herbs in breastfeeding, please
do not hesitate to call our herb information line or contact my office
direct. I'm happy to offer assistance and information whenever possible.
Wishing you health and wellness,
Tami Karnes
Certified Herbalist
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Garden of Grace Botanicals, Inc. http://www.gardenofgrace.com
1-800-230-5166 or 520-634-0078
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Date: Mon, 3 Jan 2000 11:14:09 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: "Karen Kerkhoff Gromada, MSN, RN, IBCLC" <[log in to unmask]>
Subject: Re: now I've seen everything
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In a message dated 00-01-02 16:54:57 EST, you write:
<< Subject: Now I've seen everything!
YES! YOU CAN ENLARGE AND FIRM YOUR BREASTS BY HYPNOSIS >>
Will hypnosis also work to uplift and decrease size?!?!?!!?
Karen
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Date: Mon, 3 Jan 2000 13:07:44 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "J. Rachael Hamlet" <[log in to unmask]>
Subject: Re: Vitex Agnus Castus. use? in increasing milk supply.
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I can only report my own personal experience with Vitex, which was
recommended to me by an herbalist as a remedy for heavy
menstrual bleeding. The herbalist (and the written sources I
consulted at the time) suggested that Vitex is a hormone "balancer"
and can be helpful to women who have an imbalance of estrogen
vis a vis progesterone. My guess was that my excessive bleeding
had some connection with excessive estrogen (being fat, and
knowing that fat is a resevoir of estrogen, suggested this to me). I
took Vitex daily, for the second half of my cycle (day 14 to onset of
menses) for 4 months, and saw an immediate lessening of
bleeding and pain associated with menses. The effect persisted
for about a year after I stopped taking it.
Hope this helps,
Rachael Hamlet
On 2 Jan 00, at 19:53, Esther Wiles wrote:
> It would be of interest to me to hear from any of you, who have
> recommended this herb, for increasing milk supply.
> I had a mother state that she took this and it helped to increase her
> supply. I know very little about it and my reading the insert from
> the product she took states, " studies suggest that it works to curb
> Prolactin hormone production" That this product works by slowing
> down the daily production of the hormone, to help maintain your
> normal balance. I am a little leary here and would greatly appreciate
> comments or thoughts.
>
> Esther Wiles RN, IBCLC
>
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Date: Mon, 3 Jan 2000 11:17:35 PST
Reply-To: Lactation Information and Discussion
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From: laurie wheeler <[log in to unmask]>
Subject: hypnosis
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Maybe the breasts aren't REALLY enlarged and firmer thru hypnosis, but the
client just BELIEVES that they are. Now, does this company market any pro-bf
subliminal message tapes that we can use to change the world?
Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana in s.e. USA
______________________________________________________
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Date: Tue, 4 Jan 2000 04:12:24 GMT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: Pam Easterday <[log in to unmask]>
Subject: co-sleeping
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The new (Jan/Feb 2000)Mothering magazine has lots on co-
sleeping. James McKenna writes his referenced response to
the CPSC's recommendation.
Happy New Year, Pam Easterday
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Date: Mon, 3 Jan 2000 23:28:19 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: Owens Family <[log in to unmask]>
Subject: Plugged duct in nonlactating breast?
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My name is Debbie Owens. I am a LLL Leader and have "lurked" on and off =
for several years. I want to inquire if anyone has any experience with =
a problem I am experiencing. My last child weaned 3 years ago. With =
that child I had repeated ( >12) plugged ducts in my left breast. I was =
able to ID some causal factors, attempt to avoid them, and in all but =
one case resolve the plugs early w/o antibiotics. Often I would resolve =
the plug by expressing spagetti like strands of more solid milk. I =
think I may have some tissue damage resulting from the repeated plugs =
and contributing to them. Now the problem. On several occasions in the =
last 2 years I have experienced pain and uncomfortable fullness in my =
left breast which feels like a plugged duct, even though I am no longer =
lactating. I can express drops of thick oily yellow clear =
(colostrum-like) fluid from both breasts. In my last bout with breast =
pain I tried hand expression and expressed yellow, mustard like fluid =
from one breast pore - approx. amount was 1 teaspoon. A few drops of =
white milk like fluid was expressed from a different pore. This relieved =
my breast pain temporarily. I had a normal mammogram 20 months ago, and =
will see a doctor this week. Has anyone dealt with anything like this =
before? Is it normal? Should I be concerned? Thanks for your help.=20
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Date: Mon, 3 Jan 2000 23:52:12 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: [log in to unmask]
Subject: Breast enlargement invention
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In a message dated 1/3/0 1:07:49 PM, [log in to unmask] writes:
<< A mechanism exerts a gentle pull on the breasts, whose volume increases an
average of 55% after 10 weeks, as a result of "tension-induced tissue
growth." >>
sounds like a induced lactation device. interesting research project maybe.
OR, How About This: New from *Mamco*, your dependable, non-surgical breast
enhancement provider - the "Mammoglandular Proliferater"! Much less expensive
than other deceptive devices at half the price, and less time consuming at
half the use. Just attach the intermittent tension regulator several times a
day for a several weeks and watch in amazement the spectacular mammoglandular
enhancement and nipple protractility that results! Why buy only one when you
can get two at twice the price!?!. Call now! :-D
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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Date: Tue, 4 Jan 2000 06:30:49 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Patrica Young <[log in to unmask]>
Subject: Re: policy and procedure
Comments: To: [log in to unmask]
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>Staff needs a big reminder to follow
> policy and procedure.
If you don't follow a policy and procedure having to do with say,
administration of meds, what happens? You get an incident report written
up and it goes in your file. It seems to me that if you violate ANY policy
and procedure, whether about meds, HELLP, or Breastfeeding - you get an
incident report. I think if this is clearly stated and done...people would
learn very swiftly.
I'm not sure if I'd be up for any speaking at this time, depends on what
you want me to speak on. I'm getting very out of touch with day to day in
the hospital. I left UM in 1991 :-( and although I had contact with
hospitals in Detroit via teaching students as maternity instructor, it is
still getting old.
My from-the-outside, looking-in perception at the moment is that with early
discharge moms are unprepared for engorgement and it throws them for a
loop. There is no universal close follow-up by VNA within 2-4 days so BF
is down the tubes by the time they come into the office at one-two weeks.
I perceive that the walk-in clinics connected to Evergreen Hospital is the
way to go. They are nurse run, basically free, as part of maternity care.
Moms come in for weight checks, BF tune-ups, within a day or two of
discharge and of course they are there for moms who run into problems a
little later and ins covers vss. Most babies are in limbo land for that
first mo as far as ins is concerned.
Now I think this could be easily accomodated on the maternity unit. An
empty pt. room(nearest the unit entrance), designated as drop-in room.
Outfitted with a good electronic scale, changing table and a rocking chair
or 2. Small desk and file for the LC info papers. Minimal record keeping,
ie: mom signs in name and address, baby's name and date in a log book,
weight recorded, initialed by staff member of the day who is assigned to
drop-in room. (You'd get one less mother-baby dyad to be drop-in room
person- if it got to be busy, ie:well used, get assigned a 1/2 load of pts
etc. Would depend on how your unit's census runs and volume. At Evergreen
with mega deliveries per year they have 2 FT people.)
I think we need to think outside of the box to accomodate moms/babies and
what needs to happen to encourage BF. I don't think a busy pediatric
office with sick kids present is the place to bring newborn babies and VNA
care is not universal for newborns or cost effective. And universal vss
with LCs isn't really necessary. LCs are for the mother-babies with
complicated problems. It isn't cost effective to use them as basic care.
If moms could get accurate, basic care/info in an easy, inexpensive way,
many LC vss would be averted. The use of hospital walk-in clinics would
make the vss "official", accessible, possibly guarantee that the info is
reliable-accurate and free up HCPs to work with moms and babies that need
more sophisticated help.
That's my "profound" ramble of the day :-) I'm going to send it into
Lactnet and hope it opens up a discussion :-)
Lactnet readers: this is mostly about circumstances as I see them in US.
Sincerely, Pat in SNJ
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Date: Tue, 4 Jan 2000 07:15:43 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Suzanne Bowes RN CLE <[log in to unmask]>
Subject: Milk production Rt. breast
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Dear Lactnetteres:
I have a question and curious if anyone has heard of this. Does the right
breast produce more milk than the left breast? A colleague was overhead
telling this to a new Mom. I can understand that some babies or moms could
develop a preference to one side thus indirectly influencing supply or
perhaps breast tissue/anatomy could be different in same woman. But, an
actual increase in supply for no other reason? Just wondering as I have not
heard of this before but willing to learn.
Suzanne Bowes RN, IBCLC
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Date: Tue, 4 Jan 2000 08:29:54 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Kathleen Bruce <[log in to unmask]>
Subject: Crete contact
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Does anyone know of a LLLeader or IBCLC on Crete/Greece?
Thanks. Kathleen
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
Williston, Vermont
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Date: Tue, 4 Jan 2000 10:43:57 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: [log in to unmask]
Subject: Want info on the girl whose breastfed baby died
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Anybody got any recent info on the girl who was breastfeeding her baby who
died and she was accused of murder or abuse, whichever it was? If I need to
search the archives, what key words would any of you recommend??
I'd appreciate any help you can give me.
Vickie I. Heup, RN, Lamaze International candidate
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Date: Tue, 4 Jan 2000 10:40:38 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Linda Tandy <[log in to unmask]>
Subject: Re: policy and procedure
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<My from-the-outside, looking-in perception at the moment is that with
<earlydischarge moms are unprepared for engorgement and it throws them <for
aloop. There is no universal close follow-up by VNA within 2-4 <days so
BFis down the tubes by the time they come into the office at <one-two weeks.
And many VNA nurses don't have adequate training in breastfeeding support!
I couldn't agree with you more. As a community health CNS and a lactation
consultant, I work for a hospital and developed a home visit program for our
delivering moms. Approx. 92% of our moms recieve a home visit, and we find
lots and lots of bf problems. As the milk becomes more abundant, the shape
of the nipple/breast changes, and within two days after discharge, things
are totally different!! No wonder these little ones have a hard time. We
see our moms 48 hours post discharge, which is the 4th post partum day.
Many are tearful, and so happy to see us. When I set up the program, part
of the theoretical framework was discussing how we send many newborns home
from the hospital before adequate feeding patterns are established. Where
else in the hospital do we send patients home who are unable to eat, or have
lost close to 10% of their body weight??
As I am based in the hospital, I am often dismayed as I read my fellow LC's
bashing hospital practices. There are many of us here working hard to make
the hospitals more breastfeeding friendly. Our administration was extremely
supportive of this type of program, and continue to be. I would challenge
others in the hospital to steadily, patiently bring studies/literature to
the powers that be to consider developing this type of follow-up program.
Early follow-up is essential for breastfeeding success!!
Linda J. Tandy, MSN, RN, IBCLC
Cedar Rapids, Iowa, where it is snowy and cold, bbbrrrrrrr!
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Date: Tue, 4 Jan 2000 12:01:20 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: [log in to unmask]
Subject: Stories for a Book by William Sears
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Bill and Martha Sears are currently collecting material for a book with=20=
a=20
working title of "Kids Who Turned Out Right: What Their Parents Did." They'v=
e=20
asked me, their long-time research assistant and editor, to collect stories=20
and anecdotes from families who practice co-sleeping, gentle discipline,=20
long-term breastfeeding, minimal mother-baby separation, etc., families who,=
=20
in general, make babies and children their number-one priority.=20
These might be stories about your own kids, or stories from your=20
practice. They might be about kids who are grown-up, or nearly so, or about=
=20
grade-school kids or even preschoolers and toddlers.=20
Besides using anecdotal informtion, Bill is collecting research. He=20
really wants to demonstrate that attachment parenting makes a difference.=20
This book will be published by his regular publisher, Little Brown, with all=
=20
their resources for promoting the book and its ideas. This is a chance to=20
fight back against a mainstream culture which assumes that bottle is as good=
=20
as breast, co-sleeping is dangerous, and babies and toddlers have to learn=20
who's boss.
Is there something wonderful about your kids or about families you've=20
seen in your practice that you=92d like to share with Bill and Martha and th=
eir=20
readers? Write your story or anecdote just the way you=92d tell it to=20
supportive friends=97and send it to me, Gwen Gotsch, at [log in to unmask] I=
f=20
you'd like to use actual ink on paper, my mailing address is 747 N. Humphrey=
,=20
Oak Park, IL 60302. Phone/fax 708-524-8795. =20
Thanks--and don=92t wait too long=97the manuscript is due at the publish=
er in=20
late spring.=20
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Date: Tue, 4 Jan 2000 14:46:42 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Alicia Dermer <[log in to unmask]>
Subject: breastfeeding after breast trauma
MIME-Version: 1.0
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Hi, 'netters: Happy New Year one and all! Haven't posted in a while,
going nomail intermittently. For those who don't know me, I will
reintroduce myself briefly: I am a family physician, IBCLC, president of
the New Jersey Breastfeeding Task Force, working hard to improve
breastfeeding education at the medical school and residency training
level, among others.
Now for my question. I am interested in hearing from anyone who has
worked with a mother experiencing breastfeeding problems after sustaining
blunt trauma to the breast, such as may happen with bruises from a seat
belt, etc. What kind of problems were experienced (low milk supply?
engorgement? pain?) What were the outcomes? TIA, Alicia Dermer, MD,
IBCLC.
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Date: Tue, 4 Jan 2000 14:19:14 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: Monique Schaefers <[log in to unmask]>
Subject: Guess who showed up on BabyCenter today???
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> ASK AN EXPERT:
> Why You Shouldn't Feel Guilty About Breastfeeding a Toddler
>
> ===========================================
>
> QUESTION: I have a two-year-old that I'm still nursing, but only at
> night. I assume she'll quit when she's ready. My mother-in-law thinks
> it's strange that I'm still nursing my daughter. Is she right?
>
> ANSWER by Jan Barger, RN, MA, IBCLC: It's wonderful that you are still
> nursing your daughter. She receives the physiological benefits,
> including milk tailor-made for her needs and protective immunoglobulins
> and antibodies. She also gets to enjoy the psychological benefits of
> breastfeeding, including a close relationship with you.
>
> It's not so unusual to be breastfeeding
> ( http://www.babycenter.com/refcap/1003.html ) at two or three years
> old. Worldwide, the average age of weaning
> ( http://www.babycenter.com/refcap/3272.html ) is somewhere around
> three to four years. Your child will stop breastfeeding when she is
> ready. Described as "child-led" weaning, this is the most effective and
> gentle way to wean. As long as both of you are enjoying breastfeeding,
> then by all means continue what you are doing.
>
> You might want to ask your mother-in-law what it is she finds strange
> about a woman nursing her toddler. Perhaps it simply doesn't fit in
> with her idea of what is appropriate behavior for a child your
> daughter's age. However, the more we learn about the health benefits
> of extended breastfeeding for children, as well as for mothers (such as
> reduced risk of premenopausal breast cancer, ovarian cancer, and
> osteoporosis), the more we realize that extended breastfeeding is
> normal.
--
Monique
Noah 6/97, ?? edd 6/18/00
[log in to unmask]
It will be gone before you know it. The fingerprints on the wall appear
higher and higher. Then suddenly they disappear.
Dorothy Evslin
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Date: Tue, 4 Jan 2000 21:25:01 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Stephen Curless <[log in to unmask]>
Subject: successful tongue tie/update
Comments: To: [log in to unmask]
MIME-Version: 1.0
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Hi.
Just an update on the mom with an 11 day old infant with 10%weight loss
due to tongue tie. . Birth weight was 7-4,11 days was 6-8oz. and day 14
weight was 6-14 1/2 oz. (2 days after the frenotomy.). Very thrilled to
see a 6 1/2 oz weight gain in 3 days. This mom is very pleased with the
results. Said the nursing does not hurt, baby seems to be sucking
stronger. This was a team effort of a hospital LC referring her to me,
then I referred her to the doctor who clipped the tongue. I wish this
could help get other cases done when needed.
Happy New Year. Helen CurlessRN,IBCLC
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Date: Tue, 4 Jan 2000 21:31:02 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Patrica Young <[log in to unmask]>
Subject: Re: Milk production Rt. breast
MIME-Version: 1.0
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Frequently, one breast produces more than the other. Baby preference, mom
preference, anatomical differences, who knows why, it just does, BUT it
isn't always the right breast! My niece was extremely lopsided, like an B
cup and a double D cup. After the first couple of mo she showed me her
problem. We arrived at always starting baby on small side (she had been
faithfully alternating without questioning ). Tell you colleague (is she
new at this?) not to use absolutes - always, never etc. :-) Sincerely,
Pat in SNJ
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Date: Tue, 4 Jan 2000 22:14:15 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Christine Foley <[log in to unmask]>
Subject: Black colostrum
I am a hospital based IBCLC and have been a passive member of Lactnet for
several years. I have a situation now which has me stumped and I am turning
to fellow Lactnetters for assistance. I have a patient who delivered twins
at 35 weeks by CS on 1/2/00. Twins are currently in NICU and being kept
NPO. Mother started pumping post op day 1 and reported to me when I came on
duty that night that her milk is "black". She had pumped out approximately
10 cc of dark gray colostrum. The best description I can give is a gun
metal color. The colostrum has no odor. Mother was treated for PIH with
MgSO4 x 24 hrs. post delivery and is currently on Phenobarbital. No other
significant history or medications. Mother was NPO for about 24 hours all
together before and after delivery so I don't think her diet is a factor. I
have searched the lactnet archives and found several references to dark
yellow or green colostrum but nothing about gray. Has anyone out there
encountered anything like this before? The OB is now involved and is
ordering cultures, sonograms, mamograms, and is generally alarmed. Since
the babies are still NPO I am maintaining a low profile here and trying to
gather as much info as I can. I am encouraging mother to continue pumping
and have been collecting the colostrum and storing it in the nursery
fridge. Any advice or input regarding this would be greatly appreciated.
Thanks in advance. Christine Foley, RN, IBCLC in Long Island, NY
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Date: Tue, 4 Jan 2000 21:19:40 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Christine Raasch <[log in to unmask]>
Subject: Cerebral Palsy
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Dear Colleagues
I am not asking you to look into a crystal ball and come up with a
definitive answer. What I do want is some thoughts and opinions that
might ease a mother's concern. I was working with a mother, primarily
over the telephone, who felt that her infant might be aspirating
breastmilk. She had been in to the pediatrician who observed a feeding
and thought it was an overactive let down reflex, therefore we treated
it as such. The usual recommendations helped some as did positioning.
I finally saw the mom when the infant was 6 weeks old. The infant was
barely 6 ounces above birth weight. He went to breast eagerly, but as
soon as the let down started, he had milk coming out of his nose, the
way water comes out of a bubbler/water fountain. Mom had a diaper in
place to collect all of the milk. The infant would take himself off
breast, catch his breath and resume feeding until he appeared to be
content. He was never in distress. His intake was 30 cc, the diaper
had 15 cc breastmilk. His lungs sounded awful. Mom was referred to the
pediatrician on call (that was the god send) who admitted the baby to
the hospital. The diagnosis was an enlarged upper esophageal spincter.
Although the baby never looked cyanotic, I was concerned about the
oxygen saturation and mother, who is an ICU RN was also concerned. On
admission to the hospital, his O2 sats were in the upper 80's. The
neurologist told it it was doubtful, but the word CP was used and mom is
worried. The baby is doing great. Since starting with G-tube feedings,
his weight has shot up, he's on track for growth and development, but
mom is still worrying. Our (mom's and my) question to all of you is,
have you encountered encountered anything like this in your practice?
What was the outcome in your situation? How long does it take to
diagnose CP.
On a positive note for breastfeeding, his white count was elevated on
admission to the hospital, but he never developed an infection from
aspirating breastmilk for so long.
The mother and I thank you for any information.
Christine A. Raasch, RN, IBCLC
Menomonee Falls WI
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Date: Tue, 4 Jan 2000 23:25:45 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: [log in to unmask]
Subject: dark gray colostrum
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In a message dated 1/4/0 10:26:51 PM, [log in to unmask] writes:
<< She had pumped out approximately 10 cc of dark gray colostrum. >>
Christine, was the color the same from both breast?
Deb
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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Date: Tue, 4 Jan 2000 20:45:35 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Kathleen Huggins <[log in to unmask]>
Subject: Breast trauma
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Hi Alicia! We had a mom about a year or two ago who was in a car accident
at about 30 weeks of pregnancy. The car seat belt kept her a prisoner in
the car as it started on fire after the crash. She pleaded with her
husband to get out and let her be as they had a young child at home. The
fire department arrived in the nick of time and helped her escape.
She was rushed to a community hospital where it was determined that she was
abrupting and then went into surgery for an emergency c-section. Her baby
was delivered and spend a few weeks in their NICU. The mother sent family
to us for a pump. She called us periodically complaining of a sore breast
but we could not get her to come in for us to look at her. She could never
make it in. The family was Hispanic and had transportation troubles. At
one point she went to the ER in the evening and was treated for mastitis,
although I do not think she really ever had mastitis, just this sore breast.
We finally saw her at several weeks post partum and she had a very large
mass, maybe about 10 cms or more on the upper outer quadrant of her left
breast. She was pumping milk quite successfully for her baby. I guessed
that perhaps this was a hematoma. We called our favorite surgeon and the
rest is very regrettable. We forgot to get photos! We drove her twenty
minutes away to see the surgeon. He too thought it was a hematoma and
attempted to evacuate it with a large bore needle. To everyone's surprise,
he obtained nearly 10 ounces of milk! She looked concave after the
procedure and he thought he would need to repeat this procedure again. The
breast did not fill again.
I assume that a duct tore by the seat belt and she leaked milk into her
breast early on.
End of tale!
Kathleen Huggins
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Date: Wed, 5 Jan 2000 11:59:41 +0100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Renate Rietveld IBCLC <[log in to unmask]>
Subject: Re: Black colostrum
In-Reply-To: <[log in to unmask]>
Mime-Version: 1.0
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Hi there!
This info comes from the Lactation Specialist self-study module 2.
Page 147 says:
"Black Colored Breastmilk
A semisynthetic derivative of tetracycline, minocycline hydrochloride
(Minocin), has been found in the breastmilk of women taking this drug and
has been associated with black milk. Basler and Lynch (1985) report a case
of a woman taking minocycline hydrochloride for the treatment of severe
acne for four years presenting with black milk during galactorrhea.
Physician referral is indicated for a specific diagnosis."
Hope this citation is permitted and of help.
Renate Rietveld, IBCLC
Rijswijk, The Netherlands.
At 22:14 4-1-00 -0500, you wrote:
>I am a hospital based IBCLC and have been a passive member of Lactnet for
>several years. I have a situation now which has me stumped and I am turning
>to fellow Lactnetters for assistance. I have a patient who delivered twins
>at 35 weeks by CS on 1/2/00. Twins are currently in NICU and being kept
>NPO. Mother started pumping post op day 1 and reported to me when I came on
>duty that night that her milk is "black".
--------------------------------------------------------------
Renate Rietveld, IBCLC
E-mail : [log in to unmask]
Homepage: http://www.casema.net/~rietveld/index.htm
--------------------------------------------------------------
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Date: Wed, 5 Jan 2000 06:54:07 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Patrica Young <[log in to unmask]>
Subject: Re: policy and procedure
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Dear Linda, In view of Reva Rubin's taking in and taking hold theory, pp
nurses could stand on their heads and sing BF info and the moms mostly just
won't get it! They're not ready at 24-48 hours pp to take in our messages,
instructions, etc.
The pp nurse, with her little check list, who runs thru all the info in 5
minutes and says "do you understand dear? Sign here that you understand"
is wasting everyone's time! (Unfortunately she is just following policy
:-) A long time ago Chris Mulford said they need to know 3 things before
they leave.
1. How to get the baby on so it doesn't hurt.
2. How to get the baby off so it doesn't hurt.
3. How to know if you are in trouble (ie: pain, input/output, infrequent
asking to be fed sort of stuff) and who to call if you are in trouble. (I
guess that is 4 :-)
My point is that in view of short stays we need to revise how we care for
pp women and babies. How we provide services. How we follow-up. And in
MNSHO the ins co are responsible for paying for these services. The short
stay benefits them cost wise, breastfeeding benefits them cost wise, so
providing a drop-in center for all moms (BF or not) is part of the package.
Sincerely, Pat in SNJ
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Date: Tue, 4 Jan 2000 22:06:09 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Johanna Berger <[log in to unmask]>
Subject: amoeba & giardia
Dear Netters,
Does anyone know if dihentamoeba frajilis trophoziotes (*amoeba*) can be
transferred in breastmilk? Mom also has giardia. MD wants to tx giardia
with flagyl, amoeba with chemotherapy drugs. Baby is 13 mos. Any other
suggestions. Mom really does not want to wean.
Thanks & Happy New Year!
Johanna Berger, LSW
Breastfeeding Counselor
Bala Cynwyd, PA
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Date: Wed, 5 Jan 2000 11:07:07 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Rhonda Feder <[log in to unmask]>
Subject: Re: policy and procedure
Comments: To: Patrica Young <[log in to unmask]>
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Patricia Young wrote:
"I think we need to think outside of the box to accomodate moms/babies and
what needs to happen to encourage BF. I don't think a busy pediatric
office with sick kids present is the place to bring newborn babies and VNA
care is not universal for newborns or cost effective. And universal vss
with LCs isn't really necessary. LCs are for the mother-babies with
complicated problems. It isn't cost effective to use them as basic care.
If moms could get accurate, basic care/info in an easy, inexpensive way,
many LC vss would be averted. The use of hospital walk-in clinics would
make the vss "official", accessible, possibly guarantee that the info is
reliable-accurate and free up HCPs to work with moms and babies that need
more sophisticated help."
Our peer counselling group contacts new mothers either before delivery or as
soon after as possible, depending on when we get the referral. Supposedly
all breastfeeding moms discharged from our local hospital are referred to
us. Also, referrals come from the breastfeeding class parents-to-be take at
the hospital.
Each new mom or repeat mom is assigned a counselor who remains their
counselor for the duration of breastfeeding or until the relationship is no
longer desired by the mom. We make the phone calls, with a goal of calling
new moms every other day or so in the first week, then maybe weekly for 6
weeks and tapering off to a monthly or so check in once everything is well
established and mom is comfortable nursing. We make ourselves available to
these moms by telephone and also have a hotline. We also have monthly
meetings. I suppose a potential drawback is that we are only trained to do
telephone counselling, but then again we are always able to refer to a LC,
and are trained (hopefully!) to recognize when we can't provide what the mom
needs.
Does anyone else do this type of counselling? We are all volunteers,
trained by our LCs within our group.
Rhonda Feder
Elkins Park, PA
lawyer and lay counselor
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Date: Wed, 5 Jan 2000 10:38:20 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Linda Tandy <[log in to unmask]>
Subject: Re: Yeast
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One of our LC's received a call today from a mom who has persistant thrush.
I searched the archives and found Pat Gima's thrush plan, which we will give
a try! The mom had two questions:
1. Does pumping and keeping the baby off the nipple for a few days help the
nipple to heal? She is experiencing pain with nursing.
2. Would freezing the milk kill the yeast fungus?
Two good questions and I want to give as good an answer!! Thanks in advance!
Linda J. Tandy, MSN, RN, IBCLC
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Date: Wed, 5 Jan 2000 11:41:43 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Anna Heh <[log in to unmask]>
Subject: Black colostrum
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Hi. Something to consider may be "rusty pipe syndrome." It is discussed in
Ruth Lawrence's book Breastfeeding A Guide for the medical Professional" pg.
542 fifth edition.
We have seen mothers in our hospital practice with different colors of milk.
Usually with the rusty-pipe it is old blood colored and does seem to decrease
within a few days. We have seen it brown or grayish colored . I would
assume it varies with amount of old blood in the amount of colostrum. Hope
this helps. Let us know the outcome and if they give the milk to the infant.
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Date: Wed, 5 Jan 2000 12:22:39 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Barbara Raymond <[log in to unmask]>
Subject: formula co. promo items
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I am trying to locate samples of formula company promotional items. I =
want to use them in a training activity to teach new WIC Coordinators =
about clinic barriers to breastfeeding. I don't want to to ask formula =
companies directly and give them the idea that I really want these things. =
If anyone has stuff you want to get rid of (note pads, pens, etc.) let me =
know. I'll be glad to pay for postage. =20
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Date: Wed, 5 Jan 2000 14:25:43 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Barb <[log in to unmask]>
Subject: Black colostrum
Comments: To: [log in to unmask]
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Regarding the mom who is pumping "gun metal gray" colostrum, is she a
smoker? I seem to recall Kathy Auerbach describing pumped milk from a
smoking mom with a gray hue and odor of cigarettes, but I can't find a
reference.
Barb Berges BS, RN, IBCLC
Rochester, New York
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Date: Wed, 5 Jan 2000 14:32:05 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Jeannie Zinn <[log in to unmask]>
Subject: Bloody Milk
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I have searched the archives and have some useful information on bloody
milk. I have the need of your support in hearing this case though....if you
will indulge me!
Mom is nursing her fifth child who is 6 months old and has had what she
reports as mastitis. (Soreness in one breast that phys. prescribed an
antibiotic for) After the 7 day course of antibiotic, she states, the
bloody milk is gone, but it still hurts (burning) as the baby starts to
nurse. She has no cracked nipple, reports no pinkness of the nipple, no
lumps, no signs of thrush in baby. She has called the doc back and was
given a script for Nystatin cream.....and if that doesn't work they will
move on to Diflucan.
She had bleeding again yesterday, but it has stopped.
What have I missed here? Does this sound more like Papilloma to anyone?
Thanks for your input.
Jeannie Zinn ICCE, CD(DONA), CLC
Morgantown, WV
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Date: Wed, 5 Jan 2000 15:01:03 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Lisa Papas <[log in to unmask]>
Subject: Re: need info on herb
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Happy New Year to all!!!
Life is crazy and I need some info. Has anyone here have any information on
an herb called goats rue? (sp?) I have never heard of it. Had a mom call
me that has a 3 month old baby with excellent weight gain that has (she
thinks) low milk supply since Christmas Eve. Bought this herb at a local
store that sells bf related items. Says that person at the store told her
that this is more effective than either fenugreek or blessed thistle. Is
this safe? effective? does anyone have any info? Thank
you!!!!!!!!!!!!!!!!!! Lisa P in MI
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Date: Wed, 5 Jan 2000 15:27:31 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Muriel Lafarge <[log in to unmask]>
Subject: Sterilizing by autoclave
MIME-Version: 1.0
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Dear colleagues,
I am a consulting physician at Lanaudi=E8re's Public Health department in Jo=
liette, Qu=E9bec.
A community group helping women with their breast feeding asked me a questio=
n to wich I had no satisfactory answer.
This group is offering to feeding mothers some breast-feeding material. The=
kit thez provide consists mainly of :
- a manual breast pump
- an electrical breast pump
- shields of Woolrich
- and other technical aid for breast feeding.
The community group would like to use a sterilizer (autoclave) available at =
their CLSC (local health and social services center). This way, they would =
be able to reuse part of the kt they are giving out to breast-feeding mother=
s.
Their question was about the effectiveness of this method (sterilizing by au=
toclave) to eliminate the risk of HIV and hepatits transmission.
At this time, with the help of a microbiologist and the "Leche League", i ca=
me up with a possibility for these viruses to survive this method of sterili=
zation. Furthermore, il seems Health Canada have not given out clear guidel=
ines on this matter.
I would really appreciate your opinion or any comments regarding this topic.=
You can reach me at (450) 759-1157, ext. 4454 or by fax at (450) 755-3961 =
or via e-mail at [log in to unmask]
Thank you for you help,
Muriel Lafarge, MD
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Date: Wed, 5 Jan 2000 17:01:20 -0800
Reply-To: Lactation Information and Discussion
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From: "G. Hertz" <[log in to unmask]>
Subject: Re: cerebral palsy
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Cerebral palsy is a "catch-all" term, not a specific diagnosis- regardless
of the images that come to mind when you hear the phrase. I've been
taught by some physicians that you shouldn't "diagnose" cp before 6
months old.
Sounds llike mom needs an appointment with her child's pediatrician to
clear up this issue if she's confused and worried.
Gail Hertz, MD, IBCLC
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Date: Wed, 5 Jan 2000 16:22:05 -0600
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From: Barbara Wilson-Clay <[log in to unmask]>
Organization: Austin Lactation Associates
Subject: grey milk
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There is one case study in the literature about gray or black milk produced
by a mother who had minocycline therapy. I had a daughter on this drug for
many months in tx of acne. Ask the mother if she has a hx of adolescent
acne with tx with this antibiotic. It would be prudent to do the standard
workups, but this may just be stained fluids which will flush once milk
really comes in.
Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.jump.net/~bwc/lactnews.html
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Date: Wed, 5 Jan 2000 16:25:32 -0600
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From: Barbara Wilson-Clay <[log in to unmask]>
Organization: Austin Lactation Associates
Subject: blunt trauma to breasts
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Welcome back, Alicia. I worked with a mother some years ago who sustained a
blow to the breast from a kicked soccer ball when she was about 6 mo pp.
She suffered from repeated breast infections. She was terribly sensitive to
any level of engorgement, and this would trigger systemic sx almost immed.
After several courses of antibiotics and some elaborate schemes to manage
things, she elected to follow my advice to do a unilateral weaning. It was
done on antibiotics with supervision from OB/GYN and proceeded uneventfully.
She nursed several more months on the other breast.
Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
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Date: Wed, 5 Jan 2000 18:01:51 EST
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Subject: Reva Rubin's theories
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Pat says,
<< In view of Reva Rubin's taking in and taking hold theory, pp
nurses could stand on their heads and sing BF info and the moms mostly just
won't get it! They're not ready at 24-48 hours pp to take in our messages,
instructions, etc. >>
Y'know, I've been thinking about this. Her classic work on this was
published in 1961, if I remember correctly. (I'm sure there is someone out
there who will correct me if I'm wrong...) Anyway, since I haven't read the
articles recently (probably not really since nursing school), I am wondering
if anyone knows what the labor and birth was like for the women that she
studied. Did she study women that were given the usual medications during
labor of that time which was anything from twilight sleep to general
anesthesia -- the "knock 'em out, drag 'em out" school of obstetrics? Did
she study women who had no medication or anesthesia during labor or birth?
Combination of both?
Guess I'm wondering if women really need all that long to take in and take
hold. She talked about 3 or 4 days to take in (which in 1961 was just fine
since the mothers were there forever) and then taking hold after that. How
much of this was medication related? I find that the mothers I see who have
not had ANY medication are "taking hold" virtually immediately. The ones
that had lots of medication (and usually ended up with a C/Section as well)
need a lot more time to just "be" before education of any sort is begun.
(And of course they are often on a morphine PCA pump as well). Of course,
there are exceptions to every rule, and there are lots of heavily medicated
mothers who do just fine, and other non-medicated mothers that seem to need
more time before they get it together.
I think all mothers need a lot of mothering anyway, but I'm curious about how
much labor/birth medication/anesthesia may have played into Reva Rubin's
conclusions.
Any ideas?
Jan Barger, RN, MA, IBCLC
Wheaton, IL -- near Chicago
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Date: Wed, 5 Jan 2000 18:21:02 EST
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Subject: early postpartum learning
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In a message dated 1/5/0 5:48:36 PM, Pat writes:
<< In view of Reva Rubin's taking in and taking hold theory, ........They're
not ready at 24-48 hours pp to take in our messages,instructions, etc. >>
Yes, especially if it is all new info. Early pp moms remember maybe 10% of
what they hear, a little more of what they see, a little more of what they
do.
When I worked L&D it was easy to tell in the very first few minutes which
couples had been to a prenatal BF class - not that it made them experts -
they just looked and acted like they had a clue, ie in handling the baby for
position and latch - it was *not* all new info. Seeing, hearing, and doing,
in pp bf class and @ the bedside during as many practice as possible, will
then reinforce, fill in the gaps, and increase retention. Add then the basics
of feedings, position, latch, suck, milk flow, intake, output, and wt status
guidelines in writing for referral and claification at home. Hopefully then
they will take advantage of F/U opportunities, like BF support groups.
Deb
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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Date: Wed, 5 Jan 2000 17:27:53 -0600
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From: David Swisher <[log in to unmask]>
Subject: Re: Thrush
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Linda, re: Question 2. Would freezing the milk kill the yeast fungus?
I just had a mother with this dilemma. In Breastfeeding: A Guide for the
Med Prof, p. 282, Dr. Lawrence states, "Freezing pumped breast milk while
infected with Candida does not kill the fungus. The milk must be pasteurized
or discarded."
WRT pasteurizing, my AAPL suggested the mother heat the frozen milk in a
double boiler or steamer so that there was not direct contact with the water
(and the container wouldn't melt), for about 20 minutes at a slow boil. I'd
be interested to know if anyone has had mothers do this. My niece dumped
two weeks' worth of milk for twins because of thrush:-(
Hope this is helpful.
Anna Swisher
LLL Leader
Austin, TX
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Date: Wed, 5 Jan 2000 18:20:56 -0500
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From: Kathleen Bruce <[log in to unmask]>
Subject: giardia
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Hi there. I do not believe that amoeba or Giardia can be transferred via
breastmilk. They are organisms,...how would this occur? (me, scratching my
head ! : )
Chemotherapy is the treatment for amoeba? I have not heard of this. What is
the drug protocol that they are thinking of ? Kathleen
Date: Tue, 4 Jan 2000 22:06:09 -0600
From: Johanna Berger <[log in to unmask]>
Subject: amoeba & giardia
Dear Netters,
Does anyone know if dihentamoeba frajilis trophoziotes (*amoeba*) can be
transferred in breastmilk? Mom also has giardia. MD wants to tx giardia
with flagyl, amoeba with chemotherapy drugs. Baby is 13 mos. Any other
suggestions. Mom really does not want to wean.
Thanks & Happy New Year!
I
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
Williston, Vermont
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Date: Wed, 5 Jan 2000 18:24:40 -0500
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From: Kathleen Bruce <[log in to unmask]>
Subject: Yeast
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Linda, I would recommend that you take a look at Kay Hoover's excellent
color information sheets on yeast. Her pages are wonderful
information-packed gems, and in it, you will see that freezing does not kill
fungal cells. Frozen milk can reinfect a baby down the road, apparently.
There are many treatment plans for this. I think that rather than take the
baby off the breast, it would be prudent to get her treated as soon as
possible, after a thorough assessment by her MD to confirm the diagnosis.
Jack Newman's all purpose nipple ointment is a good solution for a topical
treatment and can be used in stubborn cases of painful breastfeeding with
good results. Can someone give the url for Jack's pages on Sore Nipples?
Thrush information is contained there. Kathleen
One of our LC's received a call today from a mom who has persistant thrush.
I searched the archives and found Pat Gima's thrush plan, which we will give
a try! The mom had two questions:
1. Does pumping and keeping the baby off the nipple for a few days help the
nipple to heal? She is experiencing pain with nursing.
2. Would freezing the milk kill the yeast fungus?
Two good questions and I want to give as good an answer!! Thanks in advance!
Linda J. Tandy, MSN, RN, IBC
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
Williston, Vermont
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Date: Wed, 5 Jan 2000 19:43:35 EST
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From: Katie Allison Granju <[log in to unmask]>
Subject: Hello! Nursing past the first year
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Hi everyone. I haven't posted in a long while because I have been swamped,
but I have a question and I knew this was just the place that might have the
answer ;-) I am looking for any evidence --hard or soft -- that more mothers
in the U.S. are nursing past the first year. I strongly sense that this is
the case. In fact, my sense is that this number is rising faster than the
breastfeeding initiation rate. So anyway, can anyone point me to information
that might confirm this hunch I have?
Thanks!
Katie Allison Granju
http://www.attachmentparent.com/
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Date: Wed, 5 Jan 2000 20:36:22 -0500
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From: Patrica Young <[log in to unmask]>
Subject: Re: Reva Rubin's theories
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Later studies supported her taking in & taking hold theories, although the
time frame was shortened. I seem to remember that in spite of shorter and
shorter stays it seemed to hit a point and not get shorter. Just because
we make them take the baby home doesn't really mean they are functioning
:-) I can dig deeper this weekend. That's all I remember for now.
Sincerely, Pat in SNJ
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Date: Wed, 5 Jan 2000 20:38:39 -0500
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From: Patrica Young <[log in to unmask]>
Subject: Re: early postpartum learning
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> couples had been to a prenatal BF class - not that it made them experts -
> they just looked and acted like they had a clue, ie in handling the baby
for
> position and latch - it was *not* all new info. Seeing, hearing, and
doing,
I've noticed over the years the same sort of effect on 1st time moms who
have been to even one LLL mtg. Sincerely, Pat in SNJ
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Date: Wed, 5 Jan 2000 21:49:56 EST
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From: Cheryl Parrott <[log in to unmask]>
Subject: poor wt gain
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Hello everyone, I am very new at helping moms so I need some help with this
situation. Archival search was not very helpful. Mom has given permission
for your assistance. I have been following a 15 day old male for several
breastfeeding issues. Baby #4 for mom, first male, first bfd child.
Scheduled CS at 39 wks, birth wt 5 lbs 3 oz. Seen in office initially at day
3-4 for wt check, wt 5 lbs even, feeding ok. Does have tongue tie. Wt at
day 7 of life still 5 lbs, not latching on at that point but had horrible
thrush, which we treated. Per mom had been latching on well and feeding fine.
I then spoke to her several times on the phone at the office regarding the
baby not latching on to one breast which we treated by one sided nursing and
pumping other side. Once thrush was being treated baby had 4 days of "great
feedings" per mom. Eating q2-3 hours, no supp, voiding and stooling. I seen
them today, day 15 of life with c/o "he's eating all the time" Mom reports
2-3 days of constant feeds except for a 3 hours stretch in evening. Baby
will nurse well 15-25 minutes, both breast, fullness prior and soft after
feed, but then baby will cry and unable to pacify without feeding within 30
minutes. Mom finally broke down and supp with formula-baby took 11/2 oz and
slept for 5 hours. Wt today was only 5 lbs 1 oz, Pre/post wt revealed intake
of 11/2 oz from both breasts total in 15 min fdg session. SO...what's up.
No nipple pain or trauma, baby is latching on great, so I don't think it's
the tongue. Seems to me supply is ok.. Mom really wants to breastfeed but
obviously concerned about wt. My wonderful peds doc is waiting another day
or so to see if this self resolves- growth spurt?- or if we need to fix. You
may email me privately with any help. Sorry so long!! TIA
Cheryl Parrott BSN
Kokomo, IN
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Date: Wed, 5 Jan 2000 23:04:25 EST
Reply-To: Lactation Information and Discussion
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Subject: Black colostrum
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Dear Friends:
What is the fuss about different colored colostrum? Before pumping was so
common, no one knew about rainbow milks. Now mothers can see violet or green
or pink milk, depending on what they eat. As long as the baby takes the milk
and thrives, what difference does its color make?
Happy New Year!
Nikki Lee RN, MSN, Mother of 2, IBCLC, ICCE, CSTP
Elkins Park (a suburb of Philadelphia, Pennsylvania, northeastern USA)
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Date: Thu, 6 Jan 2000 06:25:22 -0500
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From: PrMechell Roberts Turner <[log in to unmask]>
Subject: Goat's Rue.
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Hello all ,
sorry to be so slow to get back, had a computerglitch lastnight to fix. it
wa s kalled kids hit the wrong button.
Goat's rue is fine. It does work for increasing supply and it works to help
build breast tissue. European studies have found that in animal it does
increase milk supply by as much as 50 percent. German Commission E states
safe for nursing moms.
either go to my web site or if you want qn herb info sheet just email me
privately. I also carry this herb and hand ake tinctures of it if you need
it.
mechell turner
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www.birthandbreastfeeding.com
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Date: Wednesday, January 05, 2000 6:09 PM
Subject: LACTNET Digest - 4 Jan 2000 to 5 Jan 2000 - Special issue
(#2000-11)
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Date: Thu, 6 Jan 2000 06:31:22 -0500
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From: Patrica Young <[log in to unmask]>
Subject: Re: poor wt gain
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Clip the tongue tie. Look in archives for recent discussion of tongue tie.
Mechanics for milk transfer are poor, that's why you have poor pre/post
wts. If mom's supply isn't compromised now, it will be real soon. Baby is
eating all the time because he knows he is starving. What is output -
urine and stool? Especially stool? Sincerely, Pat in SNJ
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Date: Thu, 6 Jan 2000 07:53:54 -0800
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From: Anne Andrianos <[log in to unmask]>
Subject: black colostrum
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A fellow LC reported to me that after 3 of her deliveries, she had black
colostrum, which turned to ordinary milk in the usual lenght of time.
With her fourth pregnancy, she was able to express black colostrum
prenatally. Never did she have any problems nursing her babies, and her
babies were without problems. I will ask her about antibiotic use.
Diane Wiessinger and I did a survey then a presentation on the wide
variey of colors of colostrum...and you guessed it, the range extends
from clear to black!
As Coach Linda Smith recently noted in the JHL, the profession is in
great need of more and more information on what is normal in
breastfeeding. This question about black colostrum isa great beginning
to broadening our view of normal. Thanks,
--
Anne Andrianos, MS,RN,IBCLC
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http://web.syr.edu/~afandria/
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Date: Thu, 6 Jan 2000 08:08:40 EST
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Anna:
If you search the archive I think that we have often discussed the matter
of freezing milk - part of the answer may lie in the immunocompetance of the
recipient. While the yeast is not killed by freezing ( many bakers use freeze
dried yeast ) if baby is healthy they should not become "re- infected">
Patricia
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Date: Thu, 6 Jan 2000 09:29:42 EST
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The recent discussion on breast pumps sent me back to the materials in my
files that I used to write the chapter on pumps in Riordan and Auerbach's
book. Commercial dairy milking units use two chambered teat cups where vacuum
is generated in the outside chamber which causes the softly padded inner
chamber to uniformly contract around the teat. These units were based on the
parameters of hand milking not calf suckling. I learned much about milk
extraction from the dairy farmer behind my parents farm in Pennsylvania. He
had me put my thumb into one of the teat chambers which felt like a wonderful
massage! No wonder the cows get content when they are milked! The teat
chamber does not collapse or pinch areas of the teat and it covered almost
the entire cow's teat.
The original discussion on this thread started due to a concern that the pump
flange did not cover enough of the areola and could lead to areas that were
not well drained under the edges of the flange. The Whittlestone pump used
the two chambered cup with a foam padded inner lining that contracted against
a large area of the breast. Chele Marmet tested this a number of years ago
and I believe reported that the mothers said it was an efficient and
comfortable pump to use. It was made in New Zealand. It certainly seems that
this type of pump might be a good next generation pump for the mothers we
work with. Does anyone know if the Whittlestone is still being manufactured?
Marsha Walker, RN, IBCLC
Weston, MA
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Date: Thu, 6 Jan 2000 09:35:40 EST
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In a message dated 1/6/0 12:21:53 AM, Jan writes:
<< I'm curious about how much labor/birth medication/anesthesia may have
played into Reva Rubin's conclusions. >>
good point. what an interesting research project this would make : learning/
retention medicated vs non-medicated, do a lit review including outside the
ob field, design a project for laboring women and bf ed/learning
retention/duration.
seems like this would/should have been done already.
Deb
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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Date: Thu, 6 Jan 2000 09:36:14 EST
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Subject: prenatal learning
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In a message dated 1/6/0 12:21:53 AM, Pat writes:
<< I've noticed over the years the same sort of effect on 1st time moms who
have been to even one LLL mtg. >>
LLL and hospital based bf support groups are unfortunately underutilized as a
learning resource for prenatal moms. Other than suggesting and discribing how
helpful it will be that they visit a group, how else can we
encourage/facilitate attendance?
Deb
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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Date: Thu, 6 Jan 2000 09:36:58 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: [log in to unmask]
Subject: poor wt gain
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In a message dated 1/6/0 12:21:53 AM, Cheryl writes:
<<Baby will nurse well 15-25 minutes, both breast, fullness prior and soft
after feed, but then baby will cry and unable to pacify without feeding
within 30 minutes.>>
#1) try increased time on first breast with breast massage when baby
swallowing slows - to increase hindmilk/calorie intake --> increased
satisfaction and wt gain.
<<Mom finally broke down and supp with formula-baby took 11/2 oz and
slept for 5 hours.>>
if #1 above does not work fast enough, hopefully supp can be at breast ie
sns.
<< Does have tongue tie..... baby is latching on great, >>
tongue does not jut back and forth with sucking? baby could be sucking
ineffectively after the first few minutes ie looks ok but tongue out of place.
Deb
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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Date: Thu, 6 Jan 2000 10:13:03 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Sharon Knorr <[log in to unmask]>
Subject: Re: amoeba & giardia
Comments: cc: [log in to unmask]
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Dear Johanna,
Both giardia and dientamoeba are intestinal parasites and are not generally=
ever found in the blood and therefore would not be found in breastmilk.=
Both infections are usually treated with flagyl which was once thought to=
be contraindicated while breastfeeding, but is now quite widely used to=
treat mothers and babies. Look in the archives for more information - has=
been much discussed in previous years.
Warmly,
Sharon Knorr, BSMT, IBCLC
Newark, NY - near Rochester on Lake Ontario
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Date: Thu, 6 Jan 2000 10:21:01 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Keith Lorick <[log in to unmask]>
Subject: Re: poor wt gain
Comments: To: Cheryl Parrott <[log in to unmask]>
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Cheryl,
Very often a baby with tongue-tie will appear to nurse quite well. The mom's
breast will soften, and she will see sufficient output. However, you have a
couple of tell-tale signs here that this baby needs to have his frenulum
cut.
1. He nurses all the time and doesn't seem satisified
2. He is not gaining weight
Even though there is good milk transfer, it is most probable that the only
milk this baby is receiving is foremilk. He probably does not have the
ability to strip the sinuses and elicit the ejection of hindmilk.
In this case, the milk transfer is not the result of a complete peristalsis
of the tongue, but rather of a partial peristalsis and of succion.
If the ped will clip the frenulum, you will see an immediate change.
Best of luck,
Glenni Lorick, BSE, IBCLC
Lima, Peru
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Date: Thu, 6 Jan 2000 10:32:15 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: [log in to unmask]
Subject: IBCLC needed in Mass. ASAP, please!
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I have permission from the mother to post this to Lactnet. The brother &
his wife of a very good friend of mine in Massachusetts just had a baby, and
the wife (my friend's sister-in-law) is experiencing very sore bleeding &
blistered nipples. Mom's nipples were bleeding last night when they
contacted me via Instant Message on AOL. Baby was born 1/2/2000, at Brigham
& Women's Hospital. Frankly I'm worried that it only took 3 days to get her
bleeding; poor thing. They're home from the hospital, and live in Boxford,
on the North Shore (have no idea where that is, just reporting what my
friend Deb told me).
If anyone in that area would like to make some money making a house call
today, I would consider it a personal favor. I'd go there myself if I could
afford the airfare! TIA.....
Regina Roig Lane BS IBCLC for Miami-Dade County WIC, who wishes she were in
Boxford Mass today
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Date: Thu, 6 Jan 2000 10:52:26 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Jeanette F. Panchula" <[log in to unmask]>
Subject: PP staff education
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I would like to add a fourth point to have PP teach moms:
4. When to put baby on or take baby off
in other words, getting them used to the idea of cue feeding.
Jeanette Panchula, BSW, RN, IBCLC
Vacaville, CA
mailto:[log in to unmask]
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Date: Thu, 6 Jan 2000 10:52:37 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Susan Day <[log in to unmask]>
Subject: Re: LACTNET Digest - 5 Jan 2000 (#2000-12)
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Message:
SET LACTNET NOMAIL
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Date: Thu, 6 Jan 2000 11:46:59 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: Clinical Issues in Lactation
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Dear Friends:
I received my first issue of a wonderful new professional journal today,
edited by Kathleen Auerbach. It comes from Jones and Bartlett. It is called
Clinical Issues in Lactation, and its focus is on clinical practice.
Warmly,
Nikki Lee RN, MSN, Mother of 2, IBCLC, ICCE, CSTP
Elkins Park (a suburb of Philadelphia, Pennsylvania, northeastern USA)
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Date: Thu, 6 Jan 2000 11:52:55 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "D. McCallister" <[log in to unmask]>
Subject: Product claims benefits of mother's milk
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http://www.immune-response.net/
This product appears to be claiming to fight cancer cells in the same
way that human breast milk has done in the laboratory, along with
fighting chronic fatigue syndrome and boosting the immune system...
Comments, anyone?
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Date: Thu, 6 Jan 2000 09:32:27 -0800
Reply-To: Lactation Information and Discussion
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From: "A. Allen Hulse MCP" <[log in to unmask]>
Subject: Need LC in Henderson, NV area
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A co-worker of mine has a relative in Henderson, NV, who is due in
March. She had problems nursing her first. They are requesting a LC
contact for before & after the new baby arrives. Any takers?
Judy Hulse, RN, IBCLC
Lynnwood, WA
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Date: Thu, 6 Jan 2000 11:32:00 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Kathy Dettwyler <[log in to unmask]>
Subject: thanks, plus a post on: Education/retention post-partum
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Hello all. I am here, barely. I do appreciate all the cards and letters
and children's art that you've been sending me. In the "for what it's
worth" category, having barely survived my 4th chemo treatment, and with the
blessing of my oncologist, I have decided to forego #5 and #6. "Nomo chemo
for meemo," as I like to say.
Concerning the discussion of learning and retention immediately post-partum,
I think it would be a great issue for someone to do research on. One factor
which should definitely be included is the mother's emotional state.
Emotional upset can greatly affect what one "hears." Someone who is
distraught may not only have no *memory* of what was said, but it may never
have even been processed by their brain at any level. So it's not a matter
of understanding, or of remembering, it is a process of not even hearing the
information in the first place -- even if the mother is acting engaged and
nodding her head and seeming to understand. There's an article (don't have
it handy) that describes this very eloquently -- it's an article about how
doctors should treat parents in the event that they have had a baby with
Down Syndrome. It's a "what to say, what NOT to say" kind of article, but
it talks about how parents DO NOT HEAR much of what is said to them when
they are upset about their baby.
A new mother whose baby is fine may still be emotionally upset about how
things went during labor, if she had to have an emergency C-section, even
that her husband was late or a jerk! Anyway, the point being that a
research project should include some measure of the mother's emotional state.
Kathy Dettwyler
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Date: Thu, 6 Jan 2000 12:46:58 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Laura Burnett <[log in to unmask]>
Subject: Hives in 2month old after breastfeeding
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Dear Fellow Lactnetters,
Kinda Long.........Sorry
Help! I have a situation that I would like suggestions regarding.
I have a friend, first baby, delivered 2 months ago, vaginal birth. 7 days
postpartum diagnosed with endometritis, treated with Floxin X 5 days and was
told to pump and discard breastmilk because of the medication. Which she did
and the baby was cow's milk based formula X7 days. She was told not to
resume BF for 2 days post treatment....effects of meds. Anyway she (Mom)
developed severe diarrhea during the last few days of treatment and was
hospitalized for rehydration. Baby did resume breastfeeding and has done
great. Birth weigh 7#11 and over 10# now. Beginning about 2 weeks ago, baby
developed a generalized rash and mom took him to doctor, who diagnosed an ear
infection....probably cause of rash (per doctor). Makes sense. Infant
treated X14 days with amoxicillen. Just after completing treatment, next
day, baby broke out in rash after feeding. Called doctor who stated probably
just something different (detergent, etc.). After each subsequent feeding
rash got worse.....then within 24 hours baby definitely having an allergic
reaction and developed hives during feeding. Mom rushed baby to doctor's
office, confirmed allergic reaction (hives) sent home with infant taking
Benedryl every 6 hours X 5 days. Mom calls wanting to know what to
do.......says even with Benedryl, the baby is still having some hives with
feedings.....stated "you can see him breaking out, it is not as bad as
before"
I talked with her regarding any changes soaps, detergents, foods,
medications, etc. Suggested she keep a log of her food consumption, possibly
eliminating all cow's milk and other potential allergens, eggs, etc.
Also document clearly everthing......severity of reaction, (head, face,
trunk, etc.) Time in relationship to feeding. Bath time. Diaper changes.
Also talked with her about meticulous handwashing. (Could she have touch a
potential allergen, then the baby?)
Any ideas.....what am I missing.
Thanks,
Laura Burnett RN, CLC
Fort Worth, Texas
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Date: Thu, 6 Jan 2000 19:02:53 +0100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Rachel e-mail <[log in to unmask]>
Subject: amoeba and giardia
Comments: To: [log in to unmask]
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Giardia is spread by fecal contamination. There is no way the bugs can =
migrate from the gut to the breastmilk inside the mother's body. =
Scrupulous handwashing prevents spread of infection between family =
members. Breastfeeding will also confer immunity on the child, as =
maternal antibodies appear in milk.
Over 15 years ago I had a giardia infection which required treatment. =
The public health authorities who monitored outbreaks of giardia =
informed me that children in daycare were the most common reservoir of =
infection, and often had no symptoms themselves. I had a child in =
daycare who was two and a half at the time. She was also breastfed, =
which may well be why she never developed symptoms. This was before I =
knew about the wonders of the human immune system which prioritize =
antibodies to the breastfed child.
The treatment I received was contraindicated for infants and =
breastfeeding mothers of infants. In view of the fact that my breastfed =
child was herself old enough to be treated with the same drugs if that =
had been necessary, I chose to take the treatment and not worry about =
it. If I recall correctly, the treatment was two doses 12 hours apart.
If this mother is without symptoms, I suppose she could choose not to =
treat her bugs. In my case it was out of the question as I was so =
dehydrated that breastfeeding would have had to stop for that reason.
Most parasites have a very specific and convoluted route from host to =
host, often involving more than one vector. Some diseases can be =
transmitted in any bodily fluids. Protozoans are large critters, =
microbially speaking, and don't cross epithelial barriers easily.
On the up side, it was the most effective rapid weight loss method I =
have ever experienced. Unfortunately I didn't need to lose 10 pounds at =
the time, and now that it would come in handy, I don't have a child in =
daycare any more.
Rachel Myr
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Date: Thu, 6 Jan 2000 18:05:05 +0000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: carolyn <[log in to unmask]>
Subject: grey colostrum
MIME-Version: 1.0
I have seen this several times over the last few years working as an LC
in a NICU. We gave the colostrum to the baby each time, thinking that if
the baby had been feeding directly from the breast we would not have
known that the colour was strange.
None of the babies had ill effects and the milk changed to a normal
colour during the first week.
I would love to know what caused the strange colour but was afraid to do
tests of any sort in case Mom or staff were tempted to discard the milk
pending test results.
Regards,
--
Carolyn Westcott RN IBCLC Southampton UK
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Date: Thu, 6 Jan 2000 14:22:31 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: New Journal
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Nikki Lee reported on:
<< Clinical Issues in Lactation
Dear Friends:
I received my first issue of a wonderful new professional journal today,
edited by Kathleen Auerbach. It comes from Jones and Bartlett. It is called
Clinical Issues in Lactation, and its focus is on clinical practice.>>
While I'm really eager to see this new journal, I'm a bit puzzled at the
name. The BSC Newsletter, which has been around since 1996, and is
copyrighted, is called "Clinical Issues in Lactation."
Jan Barger, RN, MA, IBCLC
Editor -- Clinical Issues in Lactation
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Date: Thu, 6 Jan 2000 13:27:53 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Lucy Towbin <[log in to unmask]>
Organization: ADH
Subject: Nursing Toddler Does Research
Someone brought up nursing past the first year and I just had to add a new
nursing toddler story to the collection I put on the list a few months ago.
An online friend has a very smart son who just started college at
Swarthmore. When he was about to turn three she decided it was time for
him to wean. She gave him a talk about how three year olds were "grown up"
and didn't need to nurse anymore. Shortly after that he was visiting at a
friend's house. The friend called his mother and said "Your son just asked
us if we would be his new parents. He says he's about to be grown up and
has to find a new home." His mom revised her plans and decided to stop
pushing the "all grown up" idea.
At some point after that (she doesn't remember exactly when) she
discovered that he had taught himself to read without her knowledge. She
has no idea how or when he did it. He would correct her when she was
reading to him and (even in a new book) skipped a word or said something
wrong. She started talking to him about weaning again and this time he
said "But mom, I read in one of your books that in some countries kids
nurse until they're seven."
I'd never heard of a child using something he'd read before to keep his
nursing relationship going!
-Lucy Towbin, MSW, IBCLC
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Date: Thu, 6 Jan 2000 13:38:22 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: gima <[log in to unmask]>
Subject: Re: Thrush/Frozen breastmilk
In-Reply-To: <001001bf57d4$7f20c300$f8d48ad1@default>
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There is debate on the issue of milk pumped when a mother and/or baby have
a yeast overgrowth. Freezing doesn't kill yeast--that we know, but whether
that milk can re-infect an infant is unknown. I beleive that if the infant
has a strong immune system, she wouldn't be infected by the excess yeast in
the milk.
But, who am I to say whether a given baby has a strong, healthy immune
system, especially if it wasn't long ago that she was battling an inbalance
in her GI tract. So I recommend erring on the side of caution. I suggest
that a mother scald her milk (bringing it to a simmer in a pot, until there
are bubbles around the edge), then letting it come to serving temperature
before feeding it to the baby. ( I add that last part because...Well you
know why.) Yeast is so unstable in heat that she doesn't need to heat it
for a long time. I do recommend that she do this in a pot so that effective
heating is throughout.
This is
After a mother and baby have worked so hard to resolve the yeast problem we
don't want to do anything to tip the balance again. I certainly don't
recommend throwing it away. I suggest that the mother use the milk that
she has scalded a couple of times a day at most, so that most of what her
baby is getting every day is the fresh stuff, with the properties that may
be lost in the heating of the frozen milk. If she is working and leaving a
lot of pumped milk, she can, each day, include a couple of bottles
containing milk that she has scalded.
I'm sure that for most babies, all of this is unnecessary, but I don't know
which babies those are. My clients seem relieved that they don't have to
throw out their hard-earned milk, and are especially relieved that they
won't be increasing their chance a recurrence.
Pat Gima, IBCLC
Milwaukee Wisconsin
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Date: Thu, 6 Jan 2000 15:23:00 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: immune-response products
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In a message dated 1/6/0 11:50:43 AM, [log in to unmask] writes:
<< Comments, anyone?>>
recently a grandmother told me she was taking the cow colostrum capsules to
enhance immune response. she explained and demonstrated with her hands how
the cow molecules interface with human molecules. interesting, in a baffling
sort of way. she also is developing some cosmetic products with a compounding
pharmacy. she was very interested in all i had to say about her daughter's
colostrum. the daughter emphatically told her mom that she had no colostrum
to spare - it's all for the baby. shades of things to come i think. when i
mentioned soothing music as a relaxation tool, the grandmother asked if
"meta" music would be best...ummm.....huh?.....she explained that meta music
synchronizes both hemispheres of the brain so she thought that would be good
for enhancing bf. ummm.....Ok - sounds good!
and i don't even live in California.
Deb
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway?
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Date: Thu, 6 Jan 2000 15:24:07 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: cue feeding
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In a message dated 1/6/0 11:50:43 AM, Jeanette writes:
<< getting them used to the idea of cue feeding. >>
yes, so important and basic. on the bf eval guidelines sheet that we give
out, feeding in response to early cues is the first issue addressed:
Squirming, Stretching, Squeaking, .......Sucking, Smacking, Searching.
Deb
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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Date: Thu, 6 Jan 2000 16:08:26 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Linda Tandy <[log in to unmask]>
Subject: Re: Reva Rubin's theories
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I do have the references to Reva Rubin's theories, and am trying to track
down all the articles, which can be a challenge. Her original study was
published in 1961, and stated the first 2-3 days the mother is "taking in"
or passive and dependent. Sometime during the third day, the new mother
becomes assertive and enters the "taking-hold" phase in which she is open to
teaching, guidance and support. L. Ament (1990) reevaluated the taking-in
and taking-hold behaviors, and reported that women's attitudes and behaviors
are consistent with Rubin's work, but the time frames have shortened. The
taking-hold stage is now thought to occur 24-48 hours after birth. As we
know most mothers having a NSVD are discharged at 48 hours or less.
Rubin published a paper in AJN in 1975, where she concluded "While much
attention has been paid to antepartal services and miracles are routine at
delivery, the big failure is in the postpartum period." Another article in
1984 by Rubin she discussed the shortened hospital stay, the gap of time
from discharge and seeing a hcp, and noted that the new mother experiences
many needs, particularly in regard to education.
In our program, we have found much of the above to be true. Mothers
frequently tell their home visit nurse that they were not instructed in
things like cord care, bathing, etc. in the hospital, where it was
documented that it was done. If you accept Rubin's hypothesis, the new
mother can't "hear" the teaching, because she if focused on her own needs of
pain and healing. You can tie Maslow's heiracy theory in with this, also.
I agree a study is needed!
References:
Ament, L. (1990). Maternal tasks of the puerperium reidentified. Journal of
Obstetric, Gynecologic, and Neonatal Nursing, 19, 330-333.
Rubin, R. (1961). Puerperal change. Nursing Outlook, 9, 753-755.
Rubin, R. (1975). Amercian Journal of Nursing, 75, (10), 1680-1684.
Rubin, R. Maternal identity and the maternal experience. New York:
Springer.
Linda J. Tandy, MSN, RN, IBCLC
Cedar Rapids, Iowa
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Date: Thu, 6 Jan 2000 17:13:48 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Current Issues in Clinical Lactation
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Dear Friends:
As you can see from the subject title of this post, I put the wrong name
for this important new journal. I apologise to the editor.
It comes from Jones and Bartlett. Their telephone number is 978-443-5000.
Their email is <[log in to unmask]> Their website is <www.jbpub.com>
I don't remember the price because I ordered it a long time ago but it is
reasonable. The journal comes bound, like a book.
I have no personal, professional, or financial attachment to CICL. Just
want to share something with 2200+ peers.
Warmly,
Nikki Lee RN, MSN, Mother of 2, IBCLC, ICCE, CSTP
Elkins Park (a suburb of Philadelphia, Pennsylvania, northeastern USA)
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Date: Thu, 6 Jan 2000 17:52:47 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Learning and Retention in the Immediate Postpartum
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There has been work done on the topic of learning and retention in the early
postpartum period. Eidelman, Hoffman and Kaitz demonstrated that new mothers
scored significantly lower on cognitive function and memory than controls.
The confusion, forgetfulness and fogginess lasted for a few days following
delivery and then dissipated. The authors stated that any information
hospital staff transmitted verbally to new mothers, especially the first day
after delivery would be easily forgotten or misunderstood. Their
recommendations included delaying giving information until the second day.
When this is not feasible, written instructions become especially important.
Eidelman A, Hoffman N, Kaitz M: Cognitive deficits in women after childbirth.
Obstetrics & Gynecology 1993; 81:764-767
This is what prompted me to use the handouts I developed for just this
purpose--written, simple, basic breastfeeding information that new mothers
need to know before they leave the hospital.
Marsha Walker, RN, IBCLC
Weston, MA
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Date: Thu, 6 Jan 2000 17:57:43 -0500
Reply-To: Lactation Information and Discussion
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From: Cathy Bargar <[log in to unmask]>
Subject: taking in, taking hold
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Thank you, Pat or whoever it was, for re-opening this discussion re: early
prenatal "education".
When I worked in the hospital (covering the period of transition from 3-5
day pp stays for NSVDs to the current 24-48 hrs), my position was called
"Patient Education & Discharge Coordinator" - in other words, I was
responsible for seeing that this early pp ed. got "done". I gave this work
my heart and soul, I whipped up all kinds of policies & procedures, I
developed all kinds of teaching tools and charting tools and standards and
all kinds of stuff. When I left the hospital, I started to hear lots of bad
stuff from professionals who saw moms pp - basically that "no one was
teaching these moms anything" - and my first conclusion was," well, that's
because they don't have old Cathy Bargar up there any more". Kind of
gratifying, to tell the truth...
My next conclusion, though, is that, exactly as Pat says, that is just not a
period of time in which women retain very much, no matter how great the
"teacher" or the program is. After I worked at WIC for a while, I had
absolute confirmation of this, as I saw women both pre- and post-delivery,
and some of them would swear that "no one ever told me______" when I *knew*
that I had discussed that very thing with them myself.
Now I'm pretty sure that only so much can be done prenatally and in those
first two or three days. And I'm pretty sure that how much is absorbed is
related to how the women themselves are cared for and treated - in other
words, women whose own individual needs are recognized and dealt with in a
manner that models good mothering (to the mom herself), who feels that *she*
has been heard and her needs addressed, will learn more efficiently how to
manage her baby & BFing experience. Which is still consistent w/Reva Rubin's
theories, because needs are different at 1 day pp than at 5 days. But
whatever stage, I'm convinced that women just plain "take in" better when
the message is wrapped in layers of loving support and gentleness. IF I were
still working at the hospital (perish the thought! - not in this lifetime,
sisters!) and IF that position were still in existence (it isn't), I would
do some things very differently. I wouldn't pretend that I was meeting new
parents' needs for "education" by rounding them up into a group class and
making them sit in an overcrowded, overheated room on their poor sore
bottoms while I "demonstrated" cord care or ran through a list of
"positions" for BFing.
And, while types of anesthesia used and other birthing policies probably do
have an impact on these stages of taking in & taking hold, I don't think it
makes nearly as big a difference as we might think. Having a baby is a
stunning experience, no matter how it's accomplished. Nowadays almost all
the women I see in private practice have had intrathecal anesthesia for
delivery, and while they may feel like they're in better shape, their babies
are clueless. Stone Cold Clueless when it comes to literally taking hold,
and sucking & swallowing efficiently. Doesn't matter how well-informed the
mother is if the babies just won't suck! We must get to the bottom of this!
Cathy Bargar RN IBCLC Ithaca NY
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Date: Thu, 6 Jan 2000 18:09:07 -0500
Reply-To: Lactation Information and Discussion
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From: Cathy Bargar <[log in to unmask]>
Subject: prenatal ed
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This is what I want women to know by the time they come home from the
hospital. All the rest is detail:
Breastfeeding is *very* important for their baby, not just a nice little
"extra something" that's nice to do as long as everything's easy. It's worth
persisting at, and there's always a way to make it work.
How to get the baby on and off.
Even more important - how to know *when* to get the baby on & off (i.e.
picking up on the baby's cues)
How to tell that it's "working" - or not, or only sort-of. And what a baby
sounds like when s/he's transferring milk efficiently.
Babies are funny little creatures, and they don't know "the rules" yet. Some
nurse "all the time". Some are very regular in their eating & excreting
patterns, and others aren't. The baby runs the show, at least at first, and
there is nothing on earth to be gained by trying to force a baby into a
pattern that doesn't suit him/her.
Who to call for help if/when they need it.
All this doesn't mean I think babies should just be dumped out on day 3 or
whatever and told to "call if you have questions". We know, because
experience tells us so (and I'm sure there are studies to back it up), that
most people *don't* call for help when they need it. They just think they're
not doing something right and either quit or struggle along till things get
either better or worse. The burden needs to be on the system to contact them
at specific times pp, not the other way around.
Cathy Bargar RN IBCLC Ithaca NY
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Date: Fri, 7 Jan 2000 11:00:17 +1100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Karleen Gribble <[log in to unmask]>
Subject: Cosleeping and SIDS
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We've just had a terrible, terrible article printed in our local paper.
Last year a friend's beautiful baby died. The coroners report come out
saying that the 'boy died of a bed-sharing sleeping incident." The NSW
Health Department has come out saying "We advise people to play with their
baby in bed but that babies should sleep in their cots". A doctor at one of
the children's hospitals is quoted as saying "The data is now well and
truly in and the warning is clear. All parents should guard against
sleeping with their babies but particularly babies who smoke" How bad
I'm going to write a letter to the paper. I know that with that study
released on sleeping with babies in the States that a lot of you have been
doing some letter writing. I know it's lazy but I have a million other
things I should be doing. Is there anyone who would be willing to share new
(late 1990s) references on cosleeping and SIDS and or any letters you have
written that I can use as a resource.
I am so angry I just can't believe it.
Karleen Gribble
Australia
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Date: Thu, 6 Jan 2000 19:53:25 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: NCAST
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Friends,
I have an opportunity to attend a four-day program to learn how to use the
NCAST feeding assessment scale. From the description, I can't tell how
relevant this would be for me, a lactation consultant. Has anyone on Lactnet
studied this assessment method? (If nobody has, I'd better sign up just so I
can tell y'all about it!)
Chris Mulford
Swarthmore PA USA
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Date: Thu, 6 Jan 2000 20:19:03 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: =?iso-8859-1?Q?Fran=E7oise?= Courville <[log in to unmask]>
Subject: Re: Current Issues in Clinical Lactation 2000
In-Reply-To: <[log in to unmask]>
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Dear Nikki Lee,
The real title of the issues is:
Current Issues in Clinical Lactation 2000 and Price: $32.00 (U.S. LIST)
"Current Issues in Clinical Lactation is a new annual publication with a
specific focus on lactation issues. CICL highlights clinical reports and
case series that illustrate particular clinical lactation problems and how
they were resolved, guiding lactation clinicians confronted by similar
conditions in daily practice".
>Dear Friends:
> I received my first issue of a wonderful new professional journal today=
,
>edited by Kathleen Auerbach. It comes from Jones and Bartlett. It is called
>Clinical Issues in Lactation, and its focus is on clinical practice.
> Warmly,
> Nikki Lee RN, MSN, Mother of 2, IBCLC, ICCE, CSTP
>Elkins Park (a suburb of Philadelphia, Pennsylvania, northeastern USA)
>
=46rancoise Courville, R.N., M.S.N., IBCLC
professor of nursing
doctoral student in education
Module des sciences de la sante
Universite du Quebec a Chicoutimi
555 boulevard de l'Universite
Chicoutimi (Quebec)
Canada G7H 2B1
Phone at work: (418) 545-5011 at home : (418) 549-1861
=46ax: (418) 545-5012
=46irst E-Mail: [log in to unmask]
Second E-Mail: [log in to unmask]
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Date: Thu, 6 Jan 2000 21:39:27 -0500
Reply-To: Lactation Information and Discussion
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From: "Jeanette F. Panchula" <[log in to unmask]>
Subject: Mother's ability to learn
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I am sure I am not the only one to have had a horrible delivery - =
1971, high forceps, vaginal delivery, 64 stitches - =
Had I not attended six La Leche League meetings prior to the delivery, I
would have had no idea what to do - what the nurses in the hospital said=
did not register. My body and bottom hurt too much - even with a long (i=
n
today's terms) stay. In fact, the only thing I remember was a sweet nun w=
ho
told my husband that I needed beer to increase my milk supply. He went o=
ut
and got a six-pack. Luckily, he drank most of it during my 5 day stay.
After discharge, I called the LLL Leaders almost daily between November a=
nd
January (jaundice, high needs baby - or was it a high needs MOM?). =
This is one reason I started a weekly support group in the hospital in
Puerto Rico that moms could come to after discharge from the hospital. T=
he
monthly LLL groups were too long in-between for the first 4-6 weeks, and
the two day stay, even with a perfect labor, did not allow time for moms =
to
recover and learn.
In my current position I am frustrated. Even with the correct education =
of
hospital nursing staff (which we still don't have), it is the postpartum
support that I think is essential. My one visit to a mom who has called
because she is having problems is NOT enough. Moms need regular,
consistent support. =
I was one of the lucky LC's who participated (VERY part-time) in the Dav=
is
study mentioned by Dr. Heinig in the JHL. The moms were SOOOO grateful f=
or
those repeated contacts - and the fact that no matter which LC they saw,
they got the same message. The support they needed, even with great
education, unusually high educational levels themselves, and a generally
supportive breastfeeding community, was much greater than even I expected=
. =
Can't wait to see the results of the study. Kudos to that team!
Jeanette Panchula, BSW, RN, IBCLC
Vacaville, CA
mailto:[log in to unmask]
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Date: Thu, 6 Jan 2000 21:42:28 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: "Cindy Curtis, RN, IBCLC" <[log in to unmask]>
Subject: ICQ ACTIVE LIST
Comments: To: LACTIVIST POST <[log in to unmask]>,
PNATALRN POST <[log in to unmask]>
I have just created an ICQ active list for breastfeeding , the list number
is 60218194
You need to have the newest version of ICQ to access the active lists.
Please go to the ICQ home page at : www.icq.com for more info. , or e mail
me!
Cindy ;-)
Cindy Curtis,RN,IBCLC
mailto:[log in to unmask]
http://www.erols.com/cindyrn
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Date: Thu, 6 Jan 2000 22:01:43 -0500
Reply-To: Lactation Information and Discussion
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From: Patrica Young <[log in to unmask]>
Subject: Re: Reva Rubin's theories and others
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"Postpartum Cognitive Deficits," A. Eidelman, N. Hoffmann & M. Kaitz.
Obstetrics & Gynecology, 81(5), 764-767. 1993.
Found that pp women have transient deficits in cognitive function.
There are other repeats of Rubin's early studies besides the one Linda
mentioned. But since my files are where you lose things alphabetically
I'll have to keep pondering what I put them under :-(
OH how does maternal role grab you?!
Rubin's "Puerperal Change" Reconsidered", L.Martell & S. Mitchell, JOGNN
1984, May/June, 13(3), p. 145-149.
mentions time frames changed.
"Reva Rubin Revisited", J.T. Gay, A.E. Edgil & A.B. Douglas, JOGNN 1988,
Nov/Dec, p. 394-399
Review of Rubin's work and theories and says more study needed in view of
social and technological changes (and that was 12 years ago :-)
Sincerely, Pat in
SNJ
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Date: Fri, 7 Jan 2000 06:54:59 +0200
Reply-To: Lactation Information and Discussion
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From: Esther <[log in to unmask]>
Subject: breastfeeding lectures
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It is Friday and I have the week-end off so I can tune in seriously to
Lactnet ( day off?) The thread about what new moms can and can't absorb
has me thinking. You want to tell me that the lectures I give EVERY
morning to a roomful of moms may be going directly into the trash bin in
their brains?
If so then we have to rethink how to present the info. I will often
speak to moms several months after birth for various questions and they
do seem to remember certain parts of my lecture. Mostly the parts that
are funny.
I agree with Cathy (welcome back, we missed you), that you have to
choose carefully the points that you want to get across and stick with
them. Present them factually and with a sense of humour......not too
funny cause the C-section moms can't laugh.
For example, I start by telling them that they will now learn to look at
their baby and not the clock, scale, or any other instrument with
numbers to breastfeed.
So of course we do hunger cues first and after I demonstrate them, I
have everyone do them with me.......it is a riot to see a room full of
adults rooting and smacking their lips, and sucking their fists....and
they remember that forever.
Next the issue of how long on each side. For that one I ask them if
when they got married if they asked their new mother-in-law how long to
let her son eat at meals...." Should I take his plate after 5 minutes,
7, 12.5 or 20?" So if not then how do you know how long to give
him? Aha! Then we do the foremilk-hind milk issue briefly and normal
nursing patterns, but we already have them thinking watch the baby not
the clock. I also do growth spurts with husband analogies and they
laugh and remember.
Next point: signs of satiety. Also a little song and dance, stand-up
comedy, whatever wakes them up...how do you know when your husband has
had enough sex? Do you look at the clock?
This lecture is of course done with babies at breast or peacefully
sleeping on moms and I think that makes them more alert. If a baby
wakes up in the middle, we stop and get him plugged in before we
continue.
The whole thing is about an hour and those moms with problems can stay
after class or come back in an hour.
I do give out a handout, but I am afraid that it gets lost in the
hundreds of printed sheets that they get and some don't even discover it
until weeks later.
Any ideas on making handouts more user friendly, and something that
won't get lost in the confusion of the early days? Print them on a
t-shirt? On pillow cases?
Tattoo them on?
Esther Grunis, IBCLC
Tel Aviv, Israel, where winter has finally shown its cold and rainy
self!! Haven't even bothered to take the winter coats out of storage.
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Date: Fri, 7 Jan 2000 16:25:01 +1100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Karleen Gribble <[log in to unmask]>
Subject: cosleeping and SIDS addition
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Sorry for the incoherence and typos in my previous message. I was angry to
the point of shaking when I wrote it. Another quote from the article that I
should have included follows.
"Pathologist Allan Cala at the Institute for Forensic Medicine found the
baby's death was most likely to be a bed-sharing sleeping accident "such
as accidental smothering or overlaying."
ie its the mums fault her baby died!!!!!!! Why is it that unexplained
death in a cot or bassinet is SIDS but unexplained death in the parents'
bed is their fault?
Karleen Gribble
Australia
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Date: Fri, 7 Jan 2000 20:34:29 +1000
Reply-To: Lactation Information and Discussion
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From: Virginia G Thorley <[log in to unmask]>
Subject: Postnatal learning
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As regards the several postings on postnatal learning: the issue here, as I
see it, is compounded by two factors: (a) medicated deliveries and (b) very
early discharge.
In supervised research I've recently completed, on postwar Queensland
women, 1945-1965, I notice that the oral advice given in hospital stuck with
them very clearly, perhaps more so that the material they read. These are
women I interviewed 35-50+ years after the birth of the first baby. The
reason why they absorbed the learning done in the hospital was that,
(a) in the early postwar years mothers stayed in the hospital for 10 days
(7-10 days, later in the 20-year period), and
(b) the learning was reinforced by *doing*, repeatedly, under supervision,
over the 10 days.
Medicated deliveries were common then, too ("twilight sleep", forceps), but
mothers were in hospital for a number of days after the drugs wore off.
They had time to develop the learning into a habit.
What postwar learned to do as a breastfeeding regimen was far from
perfect (feeds restricted by duration and interval, washing the nipples, no
rooming in, no night feeds). However, the fact I want to make is, they
learnt by repetition and doing, over a period of time.
For women on early discharge, we need to find ways to provide daily
support, including observed feeds, after discharge, to replicate some of
this learning environment. Perhaps some one has some creative ideas on how
to recreate a suitable learning environment at hoem, after discharge. Peer
counsellor programs come to mind.
If anyone want to discuss this, please email me privately. I have
family coming to stay and am going "no mail" after they arrive.
Best wishes,
Virginia
Virginia Thorley
Brisbane, Australia
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Date: Fri, 7 Jan 2000 20:49:32 +1000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Virginia G Thorley <[log in to unmask]>
Comments: To: [log in to unmask]
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To GLenni and Lactnetters,
What Glenni is describing about babies with tongue tie who look as =
if they are breastfeeding okay, but have flagging or borderline gains, =
can become *critical* down the track. Some of these babies start to get =
behind on weight gain, to the borderline of failure to thrive, after =
about eight weeks. (Obviously, this may be different ages in different =
babies.) They sometimes present at 3-4 months, with marginal weight =
gains, very frequent feeding, and a history of plugged ducts in the =
mother from the poor drainage.
At 3-4 months, the baby has more to unlearn than at age 1-2 weeks. =
If clipped at 3-4 months, they may show some improvement immediately =
after, but may take time to learn to use the increased tongue movement =
fully. A follow-up IBCLC or OT visit makes good sense, with some =
telephone follow-up.
Every case will of course be different. Please don't take the ages =
I've mentioned as set in stone.
Virginia
Virginia Thorley
Brisbane
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Date: Fri, 7 Jan 2000 12:07:41 +0100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: Learning and Retention in the Immediate Postpartum
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This again (as pointed out by others in this discussion) is a strong
rationale for prenatal bf information and instruction. Early-postpartum moms
may not learn new facts easily, they do recall waht they learned before, as
is the case in prenatal childbirth classes. Than you may want to give
written feedback for when they return home.
About the reaearch marscha referred to:
I always wonder when I hear about such outcomes *why* this occurs. Why is it
that newbormn moms are forgetfull, confused and foggy. Is it something that
has to do with medicalised birthing or is it universal? Could it be so that
mothers are meant to be foggy etc. to the outside world in order to better
be able to concentrate on their newborn?
I'd like to hear other opinions to this topic.
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
----- Oorspronkelijk bericht -----
Van: <[log in to unmask]>
Verzonden: donderdag 6 januari 2000 23:52
Onderwerp: Learning and Retention in the Immediate Postpartum
> There has been work done on the topic of learning and retention in the
early
> postpartum period. Eidelman, Hoffman and Kaitz demonstrated that new
mothers
> scored significantly lower on cognitive function and memory than controls.
> The confusion, forgetfulness and fogginess lasted for a few days following
> delivery and then dissipated. The authors stated that any information
> hospital staff transmitted verbally to new mothers, especially the first
day
> after delivery would be easily forgotten or misunderstood. Their
> recommendations included delaying giving information until the second day.
> When this is not feasible, written instructions become especially
important.
>
> Eidelman A, Hoffman N, Kaitz M: Cognitive deficits in women after
childbirth.
> Obstetrics & Gynecology 1993; 81:764-767
>
> This is what prompted me to use the handouts I developed for just this
> purpose--written, simple, basic breastfeeding information that new mothers
> need to know before they leave the hospital.
>
> Marsha Walker, RN, IBCLC
> Weston, MA
>
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Date: Fri, 7 Jan 2000 11:42:10 +0000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: heather <[log in to unmask]>
Subject: Re: cosleeping and SIDS addition
In-Reply-To: <[log in to unmask]>
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>Sorry for the incoherence and typos in my previous message. I was angry to
>the point of shaking when I wrote it. Another quote from the article that I
>should have included follows.
>
>"Pathologist Allan Cala at the Institute for Forensic Medicine found the
>baby's death was most likely to be a bed-sharing sleeping accident "such
>as accidental smothering or overlaying."
>
>ie its the mums fault her baby died!!!!!!! Why is it that unexplained
>death in a cot or bassinet is SIDS but unexplained death in the parents'
>bed is their fault?
>
>
>Karleen Gribble
>Australia
Karleen, I can understand how angry you feel at the spin put on this story,
but the basic facts of the newspaper story are probably correct.
From what we know, babies are *not* at any greater risk of SIDS if they
co-sleep with their parents (as long as the parents are not smokers). There
was a good piece in the BMJ which looked at the research in this area
(check archives - it was about 6 weeks ago). The comment from the
researchers (either in the published paper or direct to me, as I wrote up
this story for the dayjob and interviewed one of the authors, and I can't
remember if this was said or written) was that sofa deaths - where SIDS
seemed to be higher - would probably turn out to be smothering deaths, if
there was some way of distinguishing SIDS and smothering at postmortem.
Because co-sleeping promotes bf, and allows mothers and babies to be more
tuned into each other, it may actually protect against SIDS (not that I am
aware of any research that really 'proves' that).
However, bed-sharing sleeping accidents are certainly possible - see all
the discussion on the list 2-3 months ago.
Unexplained death in a cot or bassinet may well be more likely to be SIDS
than an accident, and unexplained death in parents' bed may well be more
likely to be an accident than SIDS. This should not be to blame the
parents....we urgently need good research that will allow us to encourage
safe co-sleeping, to minimise the risk of smothering, entrapment and other
risks.
Remember: adult beds today with adult bedding are *not* designed with
built-in safety features to protect small babies. Cots, cribs, prams and so
on are designed with these features. We need to be upfront about this, and
share with parents our knowledge of how to co-sleep so the baby is kept
safe.
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
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Date: Fri, 7 Jan 2000 06:39:45 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Patrica Young <[log in to unmask]>
Subject: Re: breastfeeding lectures
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Actually Esther we are saying what you say doesn't even go in (ie:
penetrate :-)
But it sounds to me like you've found some good ways in! But I'd seriously
rethink the time (1 hour), even with humor you can only get in so much
before their butts hurt too bad to pay ANY attention. What can you delete?
1/2 hour is plenty. Think of the 4-5 basic things we've mentioned and
chuck the rest. Tatoos sound like a good idea, as do pillowcases with
printed info :-)
Put your handout (1 page-both sides, clear, easy to read, no fancy typ or
artwork) on a piece of bright colored paper, hold it up, show them what's
on it and tell them to keep it handy. Put your #, hosp nursery # (they ARE
open 24 hours a day :-), local BF support group #s on pamphlet. Don't
forget KISS. (Keep it simple sweety) Sincerely, Pat in SNJ
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Date: Fri, 7 Jan 2000 06:57:22 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Patrica Young <[log in to unmask]>
Subject: Re: Learning and Retention in the Immediate Postpartum
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Dear Gonneke, it is a well known fact that mother's lose 1/2 of their brain
cells with placenta, after 2 kids you are all done in :-b
Robb has a slightly different theory, but this is the one I was always told
in Childbirth Class prep. Amazingly the cells return about a year or so
after kids grow up and leave home :-)
Seriously, I think it has to do with overload "we have produced a baby, oh
my what have we done? How will I manage? What do I do with this totally
dependent thing? Oh my body hurts, oh I'm tired." You name it. It is all
very abstract until the little bundle is actually here. experienced moms
cope much better. Sincerely, Pat in SNJ
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Date: Fri, 7 Jan 2000 13:31:03 +0000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: heather <[log in to unmask]>
Subject: letters in the BMJ about neonatal jaundice
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http://www.bmj.com/cgi/content/full/320/7227/119
which include a letter from Lactnet's Nikki Lee on bf.
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
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Date: Fri, 7 Jan 2000 08:45:30 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: [log in to unmask]
Subject: Re: LACTNET Digest - 6 Jan 2000 - Special issue (#2000-15)
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In a message dated 1/6/00 10:16:47 PM Eastern Standard Time,
[log in to unmask] writes:
<< A doctor at one of
the children's hospitals is quoted as saying "The data is now well and
truly in and the warning is clear. All parents should guard against
sleeping with their babies but particularly babies who smoke" >>
Is he also warning against buying cigarettes for " babies who smoke"!!!!!
Barbara Whitehead, IBCLC ( who just couldn't resist!!)
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Date: Fri, 7 Jan 2000 08:58:54 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: [log in to unmask]
Subject: early postpartum learning
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In a message dated 1/6/0 5:09:23 PM, Kathy D who we are glad to hear from
writes:
<< it is a process of not even hearing the information in the first place --
even if the mother is acting engaged and nodding her head and seeming to
understand. >>
and very common in peds, emergency, anywhere that unexpected things happen,
so, not uncommon in L&D. even without a bonefide distraught emotional state,
we see this all the time in the "normal" postpartum mom - she ask a question
that indicates she did not hear some new info that was given to her
yesterday, this am, 2 minutes ago - and we say "oh yes, good question" and
repeat the info as if it is the first time we ever said it, to anyone.
Deb
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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Date: Fri, 7 Jan 2000 09:24:57 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: [log in to unmask]
Subject: early postpartum learning & handouts
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In a message dated 1/7/0 8:51:23 AM, Esther writes:
<< You want to tell me that the lectures I give EVERY morning to a roomful of
moms may be going directly into the trash bin in their brains? >>
of all the new info they hear, they will remember about 10%, the seeing and
doing parts that you include in class and at the bs will increase
learning/retention. if they heard the info prenatally, it will make more
sense and be retained.
<<Any ideas on making handouts more user friendly, and something that
won't get lost in the confusion of the early days?>>
concise as possible, on as few sheets as possible, the most important info on
one sheet, colored paper, a bf logo, stapled, in folder, or in booklet form,
show and have them look at each sheet as you review contents in class
(partner or empty chair beside mom can hold papers) or at the bs, tell them
to have support persons read packet materials today, if you end up in the pt
room ask support persons to locate materials and ask if they read them and
what questions do they have, add "bf packet" to discharge check-off list that
staff fills out prior to d/c, if you speak to them on the phone p d/c, ask
them to get their bf info materials to refer to during the conversation.
Deb
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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Date: Fri, 7 Jan 2000 09:41:51 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Susan Hergert <[log in to unmask]>
Subject: How Moms Learn...and what it means for us.
Comments: cc: "[log in to unmask]" <[log in to unmask]>,
"[log in to unmask]" <[log in to unmask]>,
"[log in to unmask]" <[log in to unmask]>
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Virginia Thorley said:
"I notice that the oral advice given in hospital stuck with
them very clearly, perhaps more so that the material they read."
*************************************************************
I think this is what scares me so much. They do "latch on" to something
somebody says and follow it to a fault. It causes a kind of rigidity
that is not conducive to baby raising.
How many of you have received a call from a frantic mom on day ten who
is so upset because baby slept longer that three hours? My experience
is, that this is common. That is bad enough but....when the advice they
get is not good and they adhere to it unfailingly, the results can be
disastrous.
I agree that ongoing communication is the way to go. The home visit is
so important...but, again, the advice they get there must be research
based and must be presented in an appropriate way.
Thinking about this makes me want to recommit to follow-up calls at 1
week, two weeks and six weeks. Now, there's the issue of finding time!
Susan
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Date: Fri, 7 Jan 2000 09:52:00 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: [log in to unmask]
Subject: good mothering --->learning
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In a message dated 1/6/0 10:16:37 PM, Cathy writes:
<< ...how much is absorbed is related to how the women themselves are cared
for and treated - in other words, women whose own individual needs are
recognized and dealt with in a manner that models good mothering (to the mom
herself),.... >>
so true, and there are many ways to convey that you do care about your pt,
among those ways is, a hug, one way of mothering the mother. we have a group
of terrific female ob/gyns that hug every pt at the end of every ob or gyn
visit.
Deb
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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Date: Fri, 7 Jan 2000 09:57:23 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: "Jeanette F. Panchula" <[log in to unmask]>
Subject: NCAST
Comments: To: Chris Mulford <[log in to unmask]>
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I just took the course in October. I found it very interesting - hold yo=
ur
horses when you see incorrect positioning - and it can be very useful whe=
n
teaching health care professionals about infant cues. Right now I'm
preparing a talk to our staff based on their "Keys to Caregiving" - a way=
you could use to teach the same thing you have already taught (follow
infant cues) with the research and support of another program - which isn=
't
even breastfeeding based. =
I think it's always good to learn from experts in other fields - from the=
Feeding and Swallwing Disorders training I spoke of in previous messages =
to
the Cues, Infant feeding and teaching scales and Keys to Caregiving of
NCAST. =
If you want to know more details, please e-mail me privately.
Jeanette Panchula, BSW, RN, IBCLC
Vacaville, CA
mailto:[log in to unmask]
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Date: Fri, 7 Jan 2000 10:03:19 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: [log in to unmask]
Subject: bf support groups
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In a message dated 1/6/0 10:16:37 PM, Jeanette writes:
<< This is one reason I started a weekly support group in the hospital in
Puerto Rico that moms could come to after discharge from the hospital. >>
tell us from your experience, what factors resulted in a good group, what
factors facilitated attendance.
Deb
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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Date: Fri, 7 Jan 2000 22:42:23 +0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Joy Anderson <[log in to unmask]>
Subject: Re: poor wt gain
Comments: cc: Cheryl Parrott <[log in to unmask]>
In-Reply-To: <[log in to unmask]>
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Cheryl Parrott wrote:
> I have been following a 15 day old male for several
>breastfeeding issues. Baby #4 for mom, first male, first bfd child.
>Scheduled CS at 39 wks, birth wt 5 lbs 3 oz. Seen in office initially at day
>3-4 for wt check, wt 5 lbs even, feeding ok. Does have tongue tie. Wt at
>day 7 of life still 5 lbs, not latching on at that point but had horrible
>thrush, which we treated. Per mom had been latching on well and feeding fine.
> I then spoke to her several times on the phone at the office regarding the
>baby not latching on to one breast which we treated by one sided nursing and
>pumping other side. Once thrush was being treated baby had 4 days of "great
>feedings" per mom. Eating q2-3 hours, no supp, voiding and stooling. I seen
>them today, day 15 of life with c/o "he's eating all the time" Mom reports
>2-3 days of constant feeds except for a 3 hours stretch in evening. Baby
>will nurse well 15-25 minutes, both breast, fullness prior and soft after
>feed, but then baby will cry and unable to pacify without feeding within 30
>minutes. Mom finally broke down and supp with formula-baby took 11/2 oz and
>slept for 5 hours. Wt today was only 5 lbs 1 oz, Pre/post wt revealed intake
>of 11/2 oz from both breasts total in 15 min fdg session. SO...what's up.
>No nipple pain or trauma, baby is latching on great, so I don't think it's
>the tongue. Seems to me supply is ok.. Mom really wants to breastfeed but
>obviously concerned about wt. My wonderful peds doc is waiting another day
>or so to see if this self resolves- growth spurt?- or if we need to fix. You
>may email me privately with any help. Sorry so long!! TIA
Has food intolerance/allergy been considered here? What is output
like - lots of wet and dirty nappies, or not that many?
I have seen babies that are getting plenty of milk, having copious
output but not gaining weight. They are often unsettled, and want to
'eat all the time' (for the comfort of the sucking). When food
intolerance or allergy irritates the gut, it cannot absorb the
nutrients efficiently - it just goes in one end and out the other!
Babies often have secondary lactose intolerance caused by the gut
irritation.
The fact that the formula seemed to settle this baby may indicate
that dairy is not the problem.
Another piece here that may support this theory is the baby's problem
with thrush. I believe that thrush is often a sign of an immune
system struggling - exactly what can happen when the body is dealing
with intolerances. Also, the apparent intermittent nature of the
problem - could be related to something in mum's diet?
******************************************************************
Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Nursing Mothers' Association of Australia Breastfeeding Counsellor
Perth, Western Australia. mailto:[log in to unmask]
******************************************************************
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Date: Fri, 7 Jan 2000 08:58:10 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Kathy Dettwyler <[log in to unmask]>
Subject: User-friendly handouts
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>Any ideas on making handouts more user friendly, and something that
>won't get lost in the confusion of the early days?
For student handouts, I use different colored paper. Usually the office has
pale green, yellow, and pink, but occasionally we get flaming pink or bright
orange or yellow-orange. These work much better than white paper, which
gets lost in the shuffle.
Kathy Dettwyler
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Date: Fri, 7 Jan 2000 08:58:13 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Kathy Dettwyler <[log in to unmask]>
Subject: Why are new moms foggy?
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I'll bet if you did a careful study of hospital vs. non-hospital, medicated
vs. non-medicated, etc., you would find that most of it is due to
medications and stress of being in the hospital. In most "traditional"
cultures around the world, where mom is not medicated during labor/delivery,
and where she gives birth in a safe, secure place surrounded by people she
has known all her life, loves, and trusts, that you don't find this
fogginess. In most places, mom is back at work -- meaning hauling water,
chopping firewood, growing crops, milking animals, whatever -- by several
days postpartum. And of course, in these circumstances, even first-time
moms know all about breastfeeding because they grew up surrounded by it.
Kathy Dettwyler
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Date: Fri, 7 Jan 2000 09:31:55 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Angela Quillin <[log in to unmask]>
Subject: Article Won't print
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I really wanted a copy of that article from the BMJ on the Internet on =
neonatal jaundice, but when I try to print it, half of it is garbled. =
Does anyone know how to make it print right?
=20
Angela Quillin, WIC Project 58
Angelina County & Cities Health District
Lufkin, Texas
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Date: Fri, 7 Jan 2000 11:02:23 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: [log in to unmask]
Subject: taking in, taking hold
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Dear Friends:
The posts on this topic have been thought provoking.
What if the mothers' inability to retain cognitive information in the
immediate postpartum has to do with the artificial setting that she is in? If
she were at home, or had gone home 6 hours after delivery in a free-standing
birth center, would she be acting the same way?
There was a study showing that a certain type of primate was
argumentative and combative. The results could not be replicated in the wild,
because the subjects studied first had been studied in zoos, and animal
behavior in zoos is far different to natural animal behavior in the wild.
There is no way a hospital environment can provide privacy, which
researchers (Niles Newton jumps to mind first, then Michel Odent) have found
is necessary for birth. So could the new mother's foggy mind be an artifact
of her strange environment? How can she integrate all that she needs for this
new baby plus deal with the different sights, sounds, smells, and environment
of an artificially constructed environment?
Warmly,
Nikki Lee RN, MSN, Mother of 2, IBCLC, ICCE, CSTP
Elkins Park (a suburb of Philadelphia, Pennsylvania, northeastern USA)
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Date: Fri, 7 Jan 2000 10:03:07 -0600
Reply-To: Lactation Information and Discussion
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From: "Stearns, Crystal" <[log in to unmask]>
Subject: "Cognitive Vacation"
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After years of working with new moms my partner and I have developed a term,
definition and causal factor for a what I think all of you are talking
about. We present on it, in combination with our program on "PostPartum
Adjustment Disorder and the Breastfeeding Family" and "Bereavement and it's
impact on the Breastfeeding Family". Please feel free to use it, but do
give us credit.
Term - Cognitive Vacation
Definition - The inability to process information related to thinking,
reasoning, remembering, imagining or learning.
Causal Factors - After delivery, in Hospital
* Stress
*Fatigue
*Medication effects
*Information overload
*Environmetal overload
After going Home
*Increased stress
*Sleep depravation
*Environmental overload or Isolation
*Medical factors
*Depression or Anxiety
Hope you find this info useful. When we present we do expand on each causal
factor
Crystal Stearns RNC, MS, IBCLC
Bonnie Hollingsworth RNC, IBCLC, CCE
Mercy Memorial Health Center
Ardmore, OK 73401
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Date: Fri, 7 Jan 2000 11:11:17 -0500
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From: Cathy Bargar <[log in to unmask]>
Subject: Re: breastfeeding lectures
Comments: To: Esther <[log in to unmask]>
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Esther, you crack me up! And I know *exactly* what you're describing,
because it sounds so very much like the "classes" I used to do postpartum!
People *loved* the classes, and the other nurses refused to do them because
"we can't do it like Cathy does", and women said they found them helpful,
and *fathers* actually seemed to find them very reassuring and helpful, and
everyone said I was "so good" at doing it. I think I started to believe my
own press.
But now, several years later, I have to say that I wouldn't do the classes
the same way any more, if at all. With the early discharges we have now, I
don't think that the group classes are the most effective way to help new
moms "take in". I used to try to get them to come on the third pp day,
before discharge, so they were farther along in the taking in-taking hold
sequence, but still...
What works? I don't have a definitive answer, of course. I do think that
one-to-one may be better, and that in their own home is probably better than
in hospital, and that involving the partner or the grandma or whoever will
be helping is probably essential. I do all my LC visits at the mom's house,
because I just think that it's way easier for them, better for the babies,
and probably more effective. But who knows - Diane W. and I have had clients
go back & forth between us, and we are *very* consistent in what we say, and
they appear to have never heard the information before. But to pay for this
kind of service, in the "real world", for everyone who needs it? Fat chance!
Cathy Bargar RN IBCLC Ithaca NY
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Date: Fri, 7 Jan 2000 10:12:51 -0600
Reply-To: Lactation Information and Discussion
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From: Kathy Dettwyler <[log in to unmask]>
Subject: Hugs
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> we have a group
>of terrific female ob/gyns that hug every pt at the end of every ob or gyn
>visit.
Ordinarily, I am a very toucht-feely person, love to get and give hugs, and
my wonderful family practice doc always give my shoulder a squeeze when he
is leaving the consult room, and I like that.
However, the nurses at the chemo center *insist* on giving me a hug before I
leave, and I HATE IT. Even thinking about what they look like makes me want
to puke. Even looking at the bottle of Zofran (the anti-nausea pills) makes
me want to puke. I've heard some people start puking from chemo as they
drive into the parking lot (before they get the chemo!). I haven't figured
out a nice way to say "Keep your damn hugs to yourself." But, I don't have
to worry about it anymore.
Anyway . . . just be grumpy and saying "watch out for hugs." They may not
be appreciated.
Kathy
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Date: Fri, 7 Jan 2000 11:18:03 -0500
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From: Cathy Bargar <[log in to unmask]>
Subject: eary pp learning
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One thing I developed but never got the opportunity to try was a series of
cards (half-sheets), printed on different bright colors of paper and kept in
a bright (and simple) manila envelope. Each card had very simple, very basic
suggestions for different problems or concerns they were likely to encounter
in the 1st couple of weeks - engorgement, positioning, how to tell that it's
working well, normal variations, emotional ups & downs, different kinds of
babies, sore bottoms - all the same stuff we try to cover in those marathon
classes. The idea being that (and they would be specifically told this, and
reminded by the 1st card in the pack) they could pull out the one relevant
to their particular and specific concern at any given time and put it within
easy reach. Easier than a book, I think, and although the whole thing can be
as complex as you want it to be (and face it, it's a pretty complex area
from our point of view), each individual page is very simple and to the
point. So as not to overwhelm new parents, who definitely aren't as well
able to take in the written word as usual during this stage. Plus visually
clear, which enhances retention. (I know that I will forever and always have
a completely clear picture of Dr. Spock's section about babies' "periodic
irritable crying" - 23 years later, the book still falls open to that page.)
But I really like the pillow case idea - has anyone ever actually developed
one? Anyone want to buy the design if I come up with a good one? The thing
about this idea that I love so much is that what we most need to say is so
very simple, and a pillowcase really is an excellent "canvas", and pretty
cheap as these things go...you could do one with your phone # on it (as well
as the "Rules") as a promo giveaway. Or a cover for one of those ubiquitous
"nursing pillows" that so many women seem to have. Oooh, now I'm getting
excited about this!
Cathy Bargar RN IBCLC Ithaca NY
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Date: Fri, 7 Jan 2000 11:29:05 -0500
Reply-To: Lactation Information and Discussion
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From: Cathy Bargar <[log in to unmask]>
Subject: Taking in, taking hold
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OK, how about some of you who practice in or have studied other cultures,
where birth is NOT a medicalized event? Do women still have this pp
"fogginess"? All those mythical cultures we hear about where women have
their babies behind a bush and get right back up to work picking crops or
whatever...? Most cultures I know about have some kinds of rituals and
traditions around childbirth, which may well be to acknowledge the
mind-boggling event that happens when a person produces another person right
out of their bodies - pretty cool, huh?
And I can well imagine that in less industrialized, medicalized, etc.
places, the work that the women might be expected to get right back to is
inclusive of her new baby, and probably less demanding of a clear, sharp
mind than we seem to find "necessary" in the industrialized world. Plus
there would be more experienced mothers close at hand to guide the new
mother when she had the need of it - I can't imagine them expecting to
"learn" everything they needed to know in a 1-hr. session immediately after
(or even before) birth, or being issued a set of printed instructions!
Inquiring minds want to know!
Cathy Bargar RN IBCLC Ithaca NY
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Date: Fri, 7 Jan 2000 12:00:36 EST
Reply-To: Lactation Information and Discussion
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Kathy says,
<< I'll bet if you did a careful study of hospital vs. non-hospital, medicated
vs. non-medicated, etc., you would find that most of it is due to
medications and stress of being in the hospital. In most "traditional"
cultures around the world, where mom is not medicated during labor/delivery,
and where she gives birth in a safe, secure place surrounded by people she
has known all her life, loves, and trusts, that you don't find this
fogginess. >>
One of the reasons I posed the question in the first place (r/t Reva Rubin's
excellent studies and the relationship to medication) is that when I worked
in the alternative birthing center, I don't remember seeing this sort of
fogginess. Moms seemed to be able to "take hold" very quickly. They
remembered instructions, and seemed to be quite together. Of course, there
was no medication, no separation of mother and infant, and virtually one on
one nursing staff to family ratio, though it might be one on two during the
postpartum stay. And all our moms went home in less than 24 hours.
How many of us working with mothers and babies today *consistently* work with
mothers who have NO medication beyond a local to repair a minor laceration?
Sure, those of us that see moms in the hospital see a few mothers that don't
have meds, but as I posted to someone, I would betcha that at least 85% of
the mothers I see have something in labor -- either Stadol, Nubain, or an
epidural, or a combination thereof. I don't remember feeling foggy after my
babies were born -- spinal with the first (breech), but no meds with either
of the other two. And I still remember, 25 years later, a LOT of what went
on postpartum (including some rather ugly comments by the OB), and the lack
of teaching (after all, I was the instructor for maternity in the school of
nursing!).
So I still wonder if a lot of the inability to process information is at
least in part due to the amount of medications most mothers get during labor.
Jan Barger, RN, MA, IBCLC
Wheaton, Illinois
www.bsccenter.org
So many books, so little time!
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Date: Fri, 7 Jan 2000 12:02:12 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Cognitive Vacation
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In a message dated 1/7/0 11:03:16 AM, Crystal writes:
<< "PostPartum Adjustment Disorder and the Breastfeeding Family" and
"Bereavement and it's impact on the Breastfeeding Family".>>.
would be good if you could whip that into an article and zap over to jhl.
Deb
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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Date: Fri, 7 Jan 2000 12:07:39 -0500
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From: Susan Hergert <[log in to unmask]>
Subject: maternal adjustment: Raphael, Rubin and doulas
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Kathy D. says:
"In most "traditional"
cultures around the world, where mom is not medicated during
labor/delivery,
and where she gives birth in a safe, secure place surrounded by people
she
has known all her life, loves, and trusts, that you don't find this
fogginess."
I am sure you have a point, Kathy, but it is also true that Dana Raphael
found that it is "the presence of another person whose sole purpose it
is to care for the new mother" that made the difference for these new
moms when it came to breastfeeding.
To my mind that brings us back to Rubin's theory. Moms need a period of
taking in, in which they are cared for and have social support.....then
they can get on with the taking hold and getting back to work a little
more efficiently.
In my own research, I drew from Raphael's work and Rubin's theory to
help explain the known effectiveness of the doula. When you put Raphael,
Rubin and Kennell & Klaus together....you have a mighty powerful
argument for the care of new moms.
Susan Keith-Hergert RN, MS, CPN, IBCLC
mom, doula and lactation consultant in Cincinnati
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Date: Fri, 7 Jan 2000 12:14:15 EST
Reply-To: Lactation Information and Discussion
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Subject: bf commercial on tv
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having not read lactnet for a while until recently, this may have been
mentioned already:
last night between 4:30am and 5:30 am est there was a fabulous bf commercial -
not a commercial with bf in it, a commercial *about* bf! crawling baby
"telling" how bf is so good, how to position to bf in public, showing babies
bf in different situations. sponsered by WICs "loving support" program.
is this something new?
anyone have Dan Glickmans email address? i'd like to write a positive
feedback note of appreciation and support to encourage more of the same.
Deb
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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Date: Fri, 7 Jan 2000 11:21:34 -0600
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From: "Denny Rice, RN IBCLC, Dallas TX" <[log in to unmask]>
Organization: @Home Network Member
Subject: Nikki Lee's BMJ article
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Way to go Nikki! I just read you comments in the British Medical
Journal regarding hyperbillirubinemia as a sign of poor breastfeeding
status.
http://www.bmj.com/cgi/content/full/320/7227/119
--
Denny Rice, RN, IBCLC
Dallas Texas USA
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Date: Fri, 7 Jan 2000 12:27:55 EST
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Being an "old" childbirth educator and someone with a Master's degree in
adult eduation, I just have to jump in on this one!
Keep in mind that, in addition to postpartum "fogginess" (which I agree is a
real thing), new parents are just like everyone else. They all have
different learning styles. Only about 10% of the population learns
effectively through lecture and another 10% learns best by reading...
So, if you have a class (we now use a video at our hospital), you need to
have varied teaching techniques (short "lectures", some hands on, some bar
graphs, some written materials, maybe even a short video clip for latch).
All written materials need to be kept simple. You need graphics and "white"
space--spaces without words. The non-readers can't cope with a single-spaced
sheet too packed with words.
I try for fifth grade reading level. Really. Most professionals forget that
they use "medical-ese" out of habit. Fifth grade means 90% of the words are
two-syllable words (womb instead of uterus; nursing instead of lactation--you
get the idea).
I once saw a pictorial postoperative guide for patients--it was great!! I've
thought of using it but the graphics part stopped me. I wasn't sure I could
find/draw exactly what I wanted. I stil think it might be the best
alternative of all. Even if someone didn't speak English they could see the
pictures. Anyone want to work on this with me??
Jeanne Brotherton, RNC, IBCLC
Bellingham, Washington
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Date: Fri, 7 Jan 2000 16:39:07 +0000
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From: heather <[log in to unmask]>
Subject: Re: Hugs
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>
>Anyway . . . just be grumpy and saying "watch out for hugs." They may not
>be appreciated.
>
>Kathy
Oh, Kathy....I know what you mean.
Sometimes, formal distancing helps people cope with unpleasant procedures.
I could give loads of examples.
It's a bit like doctors and nurses thinking they are being ever so
'friendly' when they use one's first name during their care. A national
newspaper ran a campaign against this a couple of years ago here.
Older people especially find it offensive - I know my grandmother did. She
asked them to call her 'Gran' instead of 'Hilda', if they couldn't manage
Mrs Peel, and they just ignored her.... Unless you can call the doc or the
nurse by *their* first name, it's belittling. And even if you can, you
don't ncessarily want to be on first name terms with the person who is
carrying out intimate, below-the-waist, undignified procedures on your
person.
Yet when it comes to bf support, of course, I always expect first
names....no contradiction here, I hope.
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
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Date: Fri, 7 Jan 2000 11:52:10 -0600
Reply-To: Lactation Information and Discussion
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From: Kathy Dettwyler <[log in to unmask]>
Subject: Breastfeeding in breastfeeding-friendly cultures
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>more experienced mothers close at hand to guide the new
>mother when she had the need of it - I can't imagine them expecting to
>"learn" everything they needed to know in a 1-hr. session immediately after
>(or even before) birth,
I think I said it before, but I'll stress again that most first-time moms in
traditional cultures don't have anything to "learn" about breastfeeding or
taking care of newborns. They learned it all by watching, listening, and
helping as they were growing up. A new mom in Mali probably had many
younger siblings, younger half-siblings, younger cousins, younger neighbors,
and younger friends that they spent literally hundreds of thousands of hours
watching being breastfed, held, comforted, handled, cleaned up, bathed,
given medicine, etc. They know this stuff as well as they know how to walk
and talk. There is nothing NEW to learn. Girls as young as 4 years often
have complete care of infants for several hours a day except for
breastfeeding -- they bring the babies to the moms to breastfeed, obviously.
What we really need is a culture where everyone breastfeeds, and everyone
child learns about it at their mothers and neighbor's knees, and in school
from K-12 health classes, and by going to LLL meetings when pregnant, and
watching their friends and siblings and neighbors and co-workers nurse. I
know . . . . dream on.
And while I agree that Raphael's work on doulas is important, especially in
non-mother- friendly cultures like our own, it is also the case that many
societies do NOT have anyone special to take care of the mother after birth.
In Mali, the mother *may* get 3-8 days off after the birth of a baby, where
she mostly sits around and just recovers her strength and someone else does
her usual work. But if there is no one else to help, then she doesn't even
get that time off. Of course, these women are mostly in excellent physical
shape -- strong and very physically fit -- going into pregnancy and delivery
and have no labor drugs, so perhaps they recover much faster physically
because of these factors.
Kathy Dettwyler
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Date: Fri, 7 Jan 2000 13:17:36 EST
Reply-To: Lactation Information and Discussion
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In a message dated 1/7/00 11:03:24 AM Eastern Standard Time,
[log in to unmask] writes:
<< << This is one reason I started a weekly support group in the hospital in
Puerto Rico that moms could come to after discharge from the hospital. >>
tell us from your experience, what factors resulted in a good group, what
factors facilitated attendance. >>
As a former Health Dept Bfing program administrator, I would like to also
add some thoughts.
We had a series of three bfing classes for the prenatal clients: Why I should
BF my Baby, Getting Off to a Good Start with Bfing, and How to Continue with
Bfing while learning to be a parent. We also had a 3 hr evening class which
combined those topics and also going back to work or school. The key to good
attendance seemed to be the relationship the clients had with the peer
counselors and also with each other. We stressed the importance of having
friends with babies close in age so you can share the ups and downs. We also
gave transportation vouchers to help with that and encourged attendance by
key family members.
For our support group, we had topics of interest that included other topics
along with bfing. We did topics like Making Your House Child Safe, Do I
really need all this stuff? ( What are essential items for a baby?),
Regaining My Body ( diet, exercise tips which does not involve clubs or
plans), Reading Food labels and Making sense of the Food Pyramid, Ideals for
low cost Holiday gifts and celebrations. We did one entitled "Getting Rid of
the Chocolate Easter Bunny" where I got donations for baskets, grass,
celephane wrap and bows, baby sunscreen, books, balls, sunglasses, car window
shades, baby swim diapers, small disposable cameras, photo albums etc. We
discussed why each item is good for baby care and then each mom got to pick
5-6 items to put in an Easter basket and make it to take home for the baby's
first Easter. We also did clothing exchanges, toy exchanges, recipe tastings
( we had a WIC Farmers Market Cookbook which we experiemented with, etc.
Each meeting started with questions about how bfing had gone that month and
tips they could share with other moms whose baby may be at a younger age. I
think the moms really bonded together-many would ride together and sometimes
would bring a picnic to eat together after the meeting. I enjoy seeing the
moms now working together in PTAs and school groups and they often will call
me and ask about someone.
Barbara Whitehead, IBCLC
Ayden NC (Where eastern NC is just beginning to rebuild from Hurricane Floyd)
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Date: Fri, 7 Jan 2000 19:21:02 +0100
Reply-To: Lactation Information and Discussion
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From: "A. Bon" <[log in to unmask]>
Subject: Re: cosleeping and SIDS addition
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From: "heather" <[log in to unmask]>
> From what we know, babies are *not* at any greater risk of SIDS if they
> co-sleep with their parents (as long as the parents are not smokers). There
> was a good piece in the BMJ which looked at the research in this area
> (check archives - it was about 6 weeks ago).
Yes, we know..... But tell this the Dutch SIDS committee. The new official statement
is that co-sleeping is dangerous. In the paper: co-sleeping? your baby will die!
i'm so discouraged.
Annelies
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Date: Fri, 7 Jan 2000 19:11:44 +0100
Reply-To: Lactation Information and Discussion
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: good mothering --->learning
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>Deb wrote:
> so true, and there are many ways to convey that you do care about your pt,
> among those ways is, a hug, one way of mothering the mother. we have a
group
> of terrific female ob/gyns that hug every pt at the end of every ob or gyn
> visit.
>
> Deb
Do you think *all* mothers like that, Deb? I would not, personally, I do not
like relatively strangers to hug me and I do know many women around wouln'd,
either. I attended some ILCA/LLLI conferences and remenber feeling quite
upset by all those nice, but to me relatively strange women who would hug to
say hello or goodbye. I would certainly not hug my clients nor advise
collegues to do so. Still, if one is sure hugging is accepted in the culture
one works *and* the receipients like being hugged, it could be a nice way to
make mothers feel well.
Huggs at a distance, which I really do like ;-)
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
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Date: Fri, 7 Jan 2000 13:24:03 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Fogginess
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In a message dated 1/7/00 12:32:26 PM Eastern Standard Time,
[log in to unmask] writes:
<< OK, how about some of you who practice in or have studied other cultures,
where birth is NOT a medicalized event? Do women still have this pp
"fogginess"? >>
I am 10 yrs postpartum and experiencing a terrible fogginess. I have
kiddingly told my DH to put a sign on me stating where to return me if found
without my mind !!! I think it is hormonally related because I am
experiencing menopause--now 13 months since my last period. I am having hot
flashes and just started the night sweats. I am trying to use soy and avoid
ERT but am now reading and trying to decide on natural hormone replacement
treatment.
I had horrible hot flashes post partum also.
Barbara Whitehead, IBCLC
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Date: Fri, 7 Jan 2000 12:58:04 -0700
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From: Patricia Blomme <[log in to unmask]>
Subject: an idea
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Here in Alberta the dairy council has a nifty card that has a magnet placing
on the fridge. This is for tracking what you eat during the day according to
the four food groups. One has pull tags and one is wet erase.
Our postartum home visit nurses give out the on-call number for feeding
problems (or any other baby concerns) on a magnet as well.
Maybe you could incorporate these ideas into one. If the handout has a
purpose (being put on the fridge) Maybe it will go there and not get lost in
the shuffle.
Just an idea.
Patricia Blomme
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Date: Fri, 7 Jan 2000 14:51:37 -0500
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From: Lori Peters <[log in to unmask]>
Subject: breastpumps
A couple of days ago someone posted a question about a pump I had never
heard of...that got me thinking (a dangerous activity sometimes!!). I
realize that pumps are not a necessity for many moms but they are a usefull
tool to prolong breastfeeding for working moms and moms having problems.
Anyway...I am aware of the Medela and Hollister pumps, but are there others
that are out that that work as well and what is the cost comparison and how
do you locate them.
IF this is not appropriate discussion for the list...pleae email me
privatly. But, I dont think I am the only one who may be wondering this
and all the info that I have run accross is hopelessly outdated.
thanks<
Lori Peters RN IBCLC
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Date: Fri, 7 Jan 2000 14:56:36 -0500
Reply-To: Lactation Information and Discussion
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From: Patrica Young <[log in to unmask]>
Subject: Re: Why are new moms foggy?
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I agree, we don't have the extended family sort of support systems in US
and everyone lives , essentially at a distance from every one else. It
isn't as easy to watch child rearing as in a village where everyone knows
or is related to everyone else! I think the strangeness of being in
hospital instead of on your own territory increases the discomfort of labor
and leads to the need for more and more drugs. It's just a vicious cycle.
More meds, more tech and so on.
And alluding to what Nikki said, it could also be learned behavior. Lay
here in this bed, be a "good" patient and do as I say.
Unfortunately, fogginess is what we have
to work with. You & I both know it "should" or "could" be different, but
it's not. Sad. And I don't have the feeling that it is going to change
anytime soon! So sad. Sincerely, Pat in SNJ
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Date: Fri, 7 Jan 2000 15:22:08 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Hugs
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In a message dated 1/7/0 1:22:31 PM, Gonneke writes:
<< Do you think *all* mothers like that, >>
Good point, and No.
as the lc, if a mom is upset or crying, and she indicates that she wants me
there, and it "feels right" to do so, i may put my arm around her and give
her a little squeeze, if she leans towards me i hang out there till she is
calm and we can make progress. it does not happen that often and it depends
on the mom.
as for this group of docs that hug all their pts - they are a most popular
group of ob/gyns, many of the staff go to them, they always have a waiting
list of new pts, i do hear moms tell each other in pp groups that they love
their doc and make favorable comments about the hugs.
<<Huggs at a distance, which I really do like>>
{{{hug}}} back at ya :-)
Kathy D wrote:
<<the nurses at the chemo center *insist* on giving me a hug before I
leave, and I HATE IT.>>
maybe this hug is more for the nurse than the pt - the nurse has to inflict
such pain and suffering, *she* feels better to let you leave after a hug?
Deb
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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Date: Fri, 7 Jan 2000 15:22:35 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: fogginess= decreased alertness early postpartum
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In a message dated 1/7/0 12:32:31 PM, Jan writes:
<< How many of us working with mothers and babies today *consistently* work
with
mothers who have NO medication beyond a local to repair a minor laceration? >>
not me. but, many of the occasional non-medicated moms seem more alert and
energetic. maybe they get the benefit of the adrenalin rush, and the
alertness helps learning/retention during that brief hospital stay. A
research hypothesis.
Deb
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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Date: Fri, 7 Jan 2000 15:38:01 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: artificial setting
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In a message dated 1/7/0 11:03:16 AM, Nikki writes:
<< What if the mothers' inability to retain cognitive information in the
immediate postpartum has to do with the artificial setting that she is in? >>
i read something related recently about moms who become familiar with their
birthing location (ie take a tour) had less complications. so for those who
will give birth in a facility, taking a tour is better than not.
Deb
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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Date: Fri, 7 Jan 2000 15:56:09 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Re: taking in
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Cathy
as I read your post I as thinking too that in the "grand" skeem of things..
whatever you ( whoever) is saying is really insignificant to what i s oging
on for mom... this is an incredible life event and gets much more
focus/attention than anything else.
Patricia
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Date: Fri, 7 Jan 2000 15:41:52 -0600
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From: Mary Kay Smith <[log in to unmask]>
Organization: Sinai Health System
Subject: Pumping questions
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I think there are many good resources for information on ALL types of
pumps in many of our reference materials which are handy to most
LCs/RNs.
Riordan and Auerbach's book has an excellent section on pumps (written
by Marsha Walker, I think), The Breastfeeding Answer Book has a fairly
good section and my favorite is Kittie Frantz's Breastfeeding Product
Guide (info avail on her website at www.geddespro.com). I believe Marie
Biancuzzo recently wrote an excellent article for MCN or JOGGN on pumps.
(sorry but I'm 18 yrs PP and still fuzzy sometimes). The LLL Catalog
which is now on-line also has many types of pumps for sale and even tho
you might not want to buy one of each, maybe there are pictures? (The
print catalog has them.) When I was "studying" to become an LC, I
routinely went to Baby's R US and other baby stores to look at the
products available since things change so frequently. I also wrote to
some of the pump companies and asked for a sample to evaluate and show
in my prenatal class. Armed with a trusty vacuum gauge, a friend and I
tried all of them to see how they worked and how to put them together.
Many LLL Area Conferences have sessions on breastfeeding devices since
many Leaders have never used a breastpump. Hope these ideas are helpful
for getting to know the types of pumps out there.
Mary Kay Smith, CLE, IBCLC
Romeoville, IL near Chicago
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Date: Fri, 7 Jan 2000 16:39:54 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Moms' alertness--adrenalin?
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In a message dated 01/07/2000 2:56:33 PM Central Standard Time,
[log in to unmask] writes:
<< many of the occasional non-medicated moms seem more alert and
energetic. maybe they get the benefit of the adrenalin rush, >>
Just heard Dr. Righard (of Delivery Self-Attachment fame) speak in September
on his latest research. He believes non-medicated moms secrete more
endorphins, leaving them (and baby!) pain free, relaxed, yet alert in the
time immediately following birth. Consequently, moms who opt for
medication--whether or not the med has an effect on the baby--are, in
essence, depriving their babies (and themselves!) of the wonderful effects of
endorphins!
I've started using this explanation of why to minimize pain meds/epidurals in
my bf classes, and the couples seem to really consider this. Don't know if
it's had any effect on med usage....hmmm....maybe yet another study?!
Smiles--and hope to see some of ya in Orlando next week!
Carol Schlef, RNC, MSW, IBCLC
in sunny 50-ish St. Louis
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Date: Fri, 7 Jan 2000 15:22:06 -0700
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From: jhroibal <[log in to unmask]>
Subject: Fogginess in new mothers
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I just spent over an hour with my sister-in-law who just gave birth to
her third boy. She breastfed the first for 4 weeks, the second for 2
years and the third . . . remains to be seen :-)
I was helping her to latch on and is seemed like she was totally brain
dead. She was asking, "Is this okay?, When do I switch sides? How do I
hold him?" It seemed like she forget everything she ever "knew" about
breastfeeding and mothering.
During this birth, the anesthesiologist had just inserted the test-dose
epidural when the baby "popped out," in her words. She midwife barely
caught the baby.
I am suspecting this fogginess has to do with her being up for hours,
being dehydrated, she was NPO, and being distracted due to the death of
our grandmother, who died as she went into labor.
If she had this much forgetfulness as a third time mother, I wonder how
in the world first-time mothers, who may have no prior knowledge of
infants, ever catch anything said to them during the first few hours or
days PP. Plus, they may be dealing with outside family factors like,
visiting relatives, deaths, etc.
Interestingly, for my third, I gave birth at home with a midwife and I
remember the whole day and day after with startling clarity. Especially
my newborn's sounds, sights and scents. Perhaps the home setting allowed
me take in more of the total picture.
Anybody up for new father fogginess?
Heidi S. Roibal BS
Albuquerque, NM
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Date: Sat, 8 Jan 2000 08:29:33 +1000
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From: Virginia G Thorley <[log in to unmask]>
Subject: Re: LACTNET Digest - 7 Jan 2000 - Special issue (#2000-17)
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Dear Colleagues,
The discussion on postpartal learning is indeed interesting. I'd like
to add the point that there is going to be a lot of individual variation. I
like the list of factors presented by Crystal Stearns. Even so, these
factors, e.g. "stress", are going to affect different women differently.
For some of us, "stress" is stimulating. For some of us, any mental
stimulation is welcome. I am sure there are different reactions to the
other factors, such as medications and environment, too; e.g. someone who
has never been in a maternity hospital is going to find this environment
more alienating than someone who has worked there.
Just to give a personal example: When I gave birth to my 4th child,
December 1969, I went into hospital on my "due date", rather than at onset
of labour, because (a) I was very tired and badly needed a rest and (b) I
tend to have my babies quickly and lived in another town an hour away from
the hospital. I was also writing a very early draft of my first book (on
breastfeeding), and took all the writing and reference materials into
hospital with me. In the small hospital, I was able to concentrate on
writing in the six days before giving birth, dividing my time between
resting, exercising and writing. After the birth, I got straight back into
writing - well, the first day I probably spent more time enjoying my baby
and sponging her to keep her cool (100+ degrees Fahrenheit weather) and
writing baby announcement cards. I will concede that I had had a wonderful
birth, as usual *no* episiotomy, and the only discomfort was from
engorgement - despite rooming-in and (mostly) very frequent feeding - as one
afternoon my daughter refused to feed for some hours in 100+ heat, despite
sponging.
I left hospital after 5 days, and went home to 3 other children who
proceeded to cry and yell because they'd missed me so much. Despite this
potentially stressful factor, I can *still* remember the two medical journal
articles (photocopies) which were in the pile of mail I avidly opened on
arrival home. One was on iron deficiency from blood loss from the gut in
infants fed cow's milk before the age of 12 months (over 50%). The other
article was on the rise in temperature in the breast during a breastfeed.
Sorry, I cannot remember the methodology of the second article, even though
I can remember in round figures the percentage in the first article.
I offer this anecdote to illustrate that individual factors can
alleviate (or, conversely, worsen) postpartum learning or memory. I was
reading and playing mind games during labour, until I needed both hands free
to do effleurage.
Warmly,
Virginia
Virginia Thorley
In sunny Brisbane
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Date: Fri, 7 Jan 2000 15:25:56 -0700
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From: jhroibal <[log in to unmask]>
Subject: NCAST
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NCAST (Nursing Child Assessment Sattelite Training)
As a Child Development Specialist, I've attended many of classes on
growth and development, but I learned more from NCAST than most any
other class. The videos do a wonderful job os showing infant states and
cues, but don't really emphasize breastfeeding (at least, not the videos
I viewed.)
The class covers:
Infant State
Infant Behavior
Infant Cues/Communication
State Modulation
The Feeding Interaction
Nurse-Parent Communication
I really learned a lot about reading, interpreting and responding to
infant cues and overstimulation. Go for it!
Heidi S. Roibal BS
Albuquerque, NM
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Date: Sat, 8 Jan 2000 08:59:13 +1000
Reply-To: Lactation Information and Discussion
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From: Virginia G Thorley <[log in to unmask]>
Subject: postpartum memory & learning
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Dear Lactnetters:
Jan Barger wrote:
>I don't remember seeing this sort of
> fogginess. Moms seemed to be able to "take hold" very quickly. They
> remembered instructions, and seemed to be quite together. Of course,
there
> was no medication, no separation of mother and infant, and virtually one
on
> one nursing staff to family ratio, though it might be one on two during
the
> postpartum stay. And all our moms went home in less than 24 hours.
> So I still wonder if a lot of the inability to process information is at
> least in part due to the amount of medications most mothers get during
labor.
Yes, Jan. Without the stressful environment, the medicated deliveries,
and with more one-on-one, hands-on teaching (espec. at the first several
feeds), my guess is that "fogginess" isn't going to be the issue nor a
barrier to learning. (One-on-one bedside teaching takes staff time? Sure.
But doesn't it save staff time dealing with problems like babies not
latching, or readmissions.) Add some postnatal follow-up, by whatever
system is cost-effective in a given setting, using a combination of
professionals and well-trained volunteers, and Mums aren't out on a limb on
discharge.
I agree that future studies do need to look at more factors, such as
setting; any chemical or surgical interventions during labour and delivery
(and what) vs no interventions; pre-natal Bf learning; unconscious learning
from family exposure to positive breastfeeding images (e.g. seeing mother or
sister breastfeeding).
For those working in different settings, I am sure this ongoing
discussion has given an opportunity to reflect upon how to provide
information and support for their new Mums in a more effective way.
Cheers,
Virginia
Brisbane
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Date: Sat, 8 Jan 2000 09:09:28 +1000
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From: Virginia G Thorley <[log in to unmask]>
Subject: Handouts
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It is good to see the discussion on handouts, and all the creative and =
realistic ways of making new Mums aware of the BF handouts, among the =
pile of leaflets they are loaded with.
For the Mums I see, i.e. postdischarge, I put the handouts into a =
plastic sleeve (plastic sheet protector) as this is less likely to be =
mislaid.
One of the items I now include in the plastic sheet protector is the =
excellent leaflet by Rebecca Glover, an IBCLC in Western Australia. =
This fold-out leaflet has recently been revised. This works in nicely =
with what I've just demonstrated to the mother with a balloon and with =
Rebecca's laminated poster, as the illustrated steps on the poster are =
also in the brochure. (Contact me privately, if you want details. No, =
I have no conflict of interest in mentioning this resource.)
Virginia
Brisbane
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Date: Sat, 8 Jan 2000 09:13:49 +1000
Reply-To: Lactation Information and Discussion
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From: Virginia G Thorley <[log in to unmask]>
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Jeanne,
The graphics in Rebecca Glover's laminated poster and foldout =
leaflet would suit this need, especially if gone through with the Mums, =
either in a lecture or individually. Saves reinventing the wheel.
Virginia
Brisbane
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Date: Fri, 7 Jan 2000 18:04:04 -0500
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From: Cathy Bargar <[log in to unmask]>
Subject: BF in trad.cultures
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Kathy D.says <I think I said it before, but I'll stress again that most
first-time moms in
traditional cultures don't have anything to "learn" about breastfeeding or
taking care of newborns. They learned it all by watching, listening, and
helping as they were growing up.>
Yeah, in some places. In our area, I've found, for example, that the women
from many of the southeast-Asian countries (Cambodia, Laos, Viet Nam, etc.)
have had this kind of experience, and think that we're crazy in this country
to even ask about such a thing.
But on the other hand, the women I've worked with from China (even very
rural China) and especially Korea, where I think of the culture being much
more "traditional", are among the most clueless I have ever known when it
comes to BFing or indeed any aspect of care of a newborn. They have been
raised with all knowledge of childbirth and breastfeeding and baby care
being kept far from them. They often find it embarassing to discuss BFing at
all. And even women who have given birth to a previous child in their home
countries are quite without a clue what to do with their babies born here.
It appears to me that for many of these women, anything pertaining to this
whole realm is somehow not-nice, and that "respectable" young women are
sheltered from such knowledge - even when they have had their own babies.
That this open and community-based experience of BFing is maybe for
"peasants", but not for more educated or wealthy women. They certainly have
*not* grown up seeing babies nursed all around them, even in areas where
BFing is still commonly practiced, along with other traditional cultural
practices around childbearing.
I have a hard time with the idea that *all* traditional cultures deal with
BFing as simply and naturally as Kathy describes. Some do, for sure - I've
talked with many women from various countries in Africa that do, for
example - but others don't. Like menstrual taboos and practices, for
example - in some cultures menstruation is something to be concealed, in
others it's celebrated with rituals, and in others it's not a big deal one
way or the other.
But I do suspect that the "fogginess" matters less if the work you return to
is working in the fields or around the house.
Cathy Bargar RN IBCLC Ithaca NY
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Date: Fri, 7 Jan 2000 17:06:55 -0600
Reply-To: Lactation Information and Discussion
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From: Linda Tandy <[log in to unmask]>
Subject: Re: NCAST
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I, too, have taken Keys to Caregiving from NCAST, and have certified in two
NCAST assessment tools. I have found them to be pertinent to my practice,
and have thoroughly enjoyed the information. NCAST has a number of
different assessment tools, including community health tools. Although they
are not breastfeeding specific per se, they are easily applied to our
practice. I have also taught many of these concepts to NBN nurses, and find
it to be great for them, too, in recognizing states and cueing behaviors,
and in providing state-dependent care.
Catherine Barnard initiated the NCAST research in the early 70's through the
University of Washington College of Nursing. Georgina Sumner now heads up
the programming, and is an excellent teacher and mentor. I have spoken with
her several times over the years, and have found her to be enlightening.
NCAST has a website with good information, and provides an online method to
contact her. My recommendation would be go for it!
Linda J. Tandy, MSN, RN, IBCLC
Cedar Rapids, Iowa
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Date: Sat, 8 Jan 2000 00:23:46 +0100
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From: Rachel e-mail <[log in to unmask]>
Subject: Breastfeeding in breastfeeding-friendly cultures
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Breastfeeding is an example of a skill that can be learned in several =
ways, all of which end up in a physical, kinesthetic knowledge.
I was breastfed. The first time I fed my daughter I got a shock. =
Instead of the new experience I was prepared to have for the very first =
time, I felt certain clear through to my bones that I had done it =
before, and I felt that I had become my own mother, feeding me.
I watched my daughter as a toddler and preschooler 'breastfeeding' =
dolls, teddy bears, and later, her own newborn brother. She invariably =
got into a comfortable sitting position, held the doll, or bear, or =
whatever in a perfect, secure en face position, looked radiantly into =
its eyes, brought it close to her body, and shut out the rest of the =
world. She had never witnessed a bottle feeding, much less experienced =
it.
I contrast her behaviour with the practices I see among hospital staff =
when bottle feeding newborns where I work. They hold the baby at arm's =
length, facing slightly away from their own body, and converse with =
others in the room or watch TV. It makes me intensely physically =
uncomfortable.
I believe I can tell at a glance which women have never seen =
breastfeeding, or never experienced mother-baby intimacy, by watching =
the way they feed their infants. It shows clearly, regardless of =
feeding method. If my supposition is correct, my daughter will need =
very little practical or theoretical help to get started breastfeeding =
if and when the occasion should arise.
Rachel Myr
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Date: Fri, 7 Jan 2000 18:27:14 -0500
Reply-To: Lactation Information and Discussion
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From: Cathy Bargar <[log in to unmask]>
Subject: cooperative venture
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Do any of you out there have experience running a jointly-managed program -
for example, between the local WIC agency and the local breastfeeding
coalition? In our community, such a project is in the works - a grant was
written for a regional maternal-child health coalition to fund an electric
breastpump loan program for WIC participants, run by the local BFing
coalition. (Whew - what a mouthful!)
I'm wondering what others' experiences have been in this kind of cooperative
venture. The idea here is that the maternal-child coalition provides the
money for the pumps, and WIC is the main referral source for moms needing
the pumps, and the coalition (well, actually me) manages & maintains the
program, for a fee paid by this grant - doing the necessary tracking, pump
delivery & retrieval, paperwork, counseling, advising,etc.)
If any of you have experience with this, I'd like to know what worked & what
didn't. It seems like a great idea to me - I wonder what we're missing!
Cathy Bargar RN IBCLC Ithaca NY
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Date: Fri, 7 Jan 2000 18:32:32 EST
Reply-To: Lactation Information and Discussion
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From: Theresa Chmiel <[log in to unmask]>
Subject: Re: movie quote
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In a message dated 12/20/99 3:44:32 PM Central Standard Time,
[log in to unmask] writes:
<< After one especially rude comment from the lawyer, Robin Williams turns to
the lawyer's mother and says "Did he not breastfeed?"
My entire family broke into spontaneous applause!
>>
So did I!!
Theresa Chmiel, CLC, ICCE
Las Vegas, NV
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Date: Fri, 7 Jan 2000 18:50:30 EST
Reply-To: Lactation Information and Discussion
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From: Theresa Chmiel <[log in to unmask]>
Subject: Abbott's claims-YUK
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This was on my clipper service. Yuk.
I thought breastmilk was the first choice of doctors.
Theresa Chmiel, CLC
Abbott's Similac(R) is the First Choice of Doctors
ABBOTT PARK, Ill., Jan. 7 /PRNewswire/ -- The Ross Products Division of
Abbott Laboratories (NYSE: ABT) has received a favorable ruling allowing it
to resume use of the claim "1st Choice of Doctors" in advertising its
Similac(R) infant formulas.
On January 5, 2000, the United States Court of Appeals for the Seventh
Circuit reversed the opinion of the United States District Court for the
Southern District of Indiana in a case brought by Mead Johnson, makers of
Enfamil(R). The lower court had temporarily barred Abbott from using the
claim "1st Choice of Doctors" on advertising or labeling for Similac -- but
had recognized the validity of the claim for Isomil(R).
In issuing its opinion, the appellate court found that the "absolute and
relative preferences for Similac are substantial." The court stated that
"more than a score of surveys show that pediatricians prefer Similac over
Enfamil..." and that in those surveys Enfamil never beats Similac. In fact,
a number of those surveys showed Similac is preferred by doctors 2 to 1 over
Enfamil -- "in politics this would be a landslide," said the court.
"Abbott research has demonstrated that its Similac and Isomil brands are the
first choice of doctors and we know that physicians' specific brand
recommendations are important to parents," said Joy Amundson, president of
the Ross Products Division of Abbott Laboratories. "Abbott is pleased with
the court's decision recognizing what we have always maintained, that Similac
and Isomil are the first choice of doctors and are preferred over Enfamil and
other infant formulas. Our claims are truthful and substantiated," said
Amundson.
The Ross Products Division of Abbott Laboratories is a longtime leader in the
United States and international marketplace, well known for the manufacturing
and marketing of leading brands such as Similac infant formula and Ensure(R)
adult nutritional products.
Abbott Laboratories is a global, diversified health care company devoted to
the discovery, development, manufacture and marketing of pharmaceutical,
diagnostic, nutritional and hospital products. The company employs 56,000
people and markets its products in more than 130 countries.
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Date: Fri, 7 Jan 2000 20:31:20 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Re: Taking in, taking hold - fogginess
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In a message dated 1/7/00 10:03:24 AM Central Standard Time, Nikki Lee writes:
<< So could the new mother's foggy mind be an artifact
of her strange environment? How can she integrate all that she needs for this
new baby plus deal with the different sights, sounds, smells, and environment
of an artificially constructed environment? >>
I'm sure that "birth in captivity" is inherently different than in birth in a
more natural (home) setting. I'm also thinking fogginess has to do with the
kind of care received and not just the anesthesia. During my first
(hospital) birth the nurses were very interested in things they could measure
- how many cms, how many minutes, how high the peaks on the graph paper were,
how much fluid, how many seconds pushing, etc. During my second birth (and
prenatal care) the midwife was interested in tuning in to me and reading more
subtle cues. It was hard for me after the birth of my first child to adjust
to the idea that there wasn't an answer book, no exact measurements, no
precise timing. Learning my baby's cues, and trusting them, was very
difficult. But I wasn't foggy at all about my unfinished accounting job and
made calls the same day to handle open items. After the birth of my second
child I had no trouble with the natural rhythms of life (or bf) - but found
concentrating on logical, measurable tasks (balancing the checkbook)
difficult and tedious.
I'm remembering a study that indicated that women who had good emotional
support during labor (doulas?) displayed more affection to their babies at
three months pp. Stepping way out on a limb...I wonder if the birth process
opens up the brain to new ways of processing information and exactly how
those synapses develop is related to the birth experience. I heard some
technical session about hormonal (oxytocin) receptors at the LLLI conference
that made me realize how complex our biological processes are and how well
they can explain behavior once we understand them.
Elaine Ziska
Jackson, MS
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Date: Fri, 7 Jan 2000 17:56:47 -0800
Reply-To: Lactation Information and Discussion
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From: Joan Edelstein <[log in to unmask]>
Subject: Video info needed
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We're looking for a good video on hand expression of milk during the
neonatal period. Any resources?
Thanks!!
Joan
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Date: Fri, 7 Jan 2000 21:27:11 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Breastfeeding in breastfeeding-friendly cultures
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In a message dated 1/7/0 3:57:33 PM, Kathy writes:
<< ...first-time moms in
traditional cultures don't have anything to "learn" about breastfeeding or
taking care of newborns. They learned it all by watching, listening, and
helping as they were growing up...... >>
and i admit as much to expectant parents: i tell prenatal classes that the
only reason i have a job right now teaching prepared childbirth and
breastfeeding is because most of us did not grow up watching our female
relatives and friends birth and breastfeed their babies. i think this helps
expectant parents understand why they are there in class.
maybe the lc profession will one day be just an interesting topic in US
sociology classes.
Deb
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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Date: Fri, 7 Jan 2000 21:28:49 EST
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From: [log in to unmask]
Subject: bf support groups
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Barbara, thank you for your thoughts and helpful suggestions for good support
groups.
The new moms group that I facilitate has a community service project
available to those who wish to participate. Over the years the moms in this
mostly affluent group would ask where they could donate unneeded baby care
items and clothing. I would direct them to various wide spread community
groups that the new moms could not get to. As a convenience to the group
moms, I now I collect the items and interoffice mail them to the ob clinic
for service pts at the hospital where I work. The group moms seem to like
this close connection in helping underprivileged moms.
Deb
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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Date: Fri, 7 Jan 2000 18:50:35 PST
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From: Vicki Insley <[log in to unmask]>
Subject: Re: fogginess
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I know in my own experience with having ten (10) children, the first five I
had totally natural and can still remember each birth very clearly even
though the oldest is 26 yrs. old. The last five were born by c-section and
it was days before I felt I was with it because of all the medications. It
made me very angry for feeling that way and I knew even then it was due to
all the medications. It is very dissappointing not to remember things
concerning your childrens' births and the following days after because you
were so drugged.
Vicki Insley
LLL Leader
Findlay, OH mother to ten and grandmother to six and also a full-time
student.
______________________________________________________
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Date: Fri, 7 Jan 2000 21:47:30 -0600
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From: "Denny Rice, RN IBCLC, Dallas TX" <[log in to unmask]>
Organization: @Home Network Member
Subject: pp fogginess
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Perhaps the fogginess is nature's way of helping us to "forget" the
labor, concetrate on the baby, and maybe even be willing to have another
someday!
--
Denny Rice, RN, IBCLC
Dallas Texas USA
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Date: Fri, 7 Jan 2000 21:33:12 -0600
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From: Susan R Potts <[log in to unmask]>
Subject: To Hug or Not to Hug
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Dear Kathy D. and all,
Yeah, that hugging thing can be comfortable or uncomfortable. I go
between liking and disliking hugs.......maybe it's related to hormonal
swings.......??? It's good to try to "feel out" without feeling the
other person. Sometimes you can ask, or wait and look for open or closed
body language; or a hand shake is enough, or a pat on the arm or
shoulder.
Reminds me of something that happened before Christmas during an out
patient consult with a mom, dad, and baby. I used the word "team" while
explaining how the first couple weeks of breastfeeding are a team effort
involving all 3 of them. The dad's eyes just lit up like a light bulb
turning on with the word team! I thought, Oh......that's a "guy word";
and this dad really seemed able to relate!!
Susan Potts rn ibclc
Minnesota
Enjoying a set of Patsy Cline cd's while mixing up my Best
Buttermilk Pancakes for
the week end.
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Date: Fri, 7 Jan 2000 22:56:09 EST
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From: "Sharon Healy RN,IBCLC" <[log in to unmask]>
Subject: Dr Jack Neqmans address
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Hi , Happy New Year !! I am looking for Dr Jacks e mail address. He is
doing a talk here o;n Buffalo Tuesday and I wanted to email him prior. If you
have it could you please private email me? Thank you Sharon
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Date: Fri, 7 Jan 2000 23:13:07 -0500
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From: AEG <[log in to unmask]>
Subject: subscribe
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Date: Fri, 7 Jan 2000 23:21:54 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: "Airplane safety cards" for patient education
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In a message dated 1/7/2000 12:32:21 PM Eastern Standard Time,
[log in to unmask] writes:
<< I once saw a pictorial postoperative guide for patients--it was great!!
I've
thought of using it but the graphics part stopped me. I wasn't sure I could
find/draw exactly what I wanted. I stil think it might be the best
alternative of all. Even if someone didn't speak English they could see the
pictures. Anyone want to work on this with me??
>>
Jeanne, this is so smart! It makes me think of the safety cards on
airplanes. There, too, they 1) want everybody to understand it, 2) are
telling it to you before you need it but want you to remember it later, and
3) you can find it quickly in the stuffed seat pocket, even if its full of
magazines and tissues and ticket stubs, and 4) if you do need to check it
later, when the emergency is happening, they want you to quickly be able to
locate on it the specific information you need.
The more I think of it, the more I think that -- if you can afford to print
in color, but it can't be much more pricey than, well, a pillow case, now
that so many institutions have color printers or color photocopiers -- this
might really be a great model for patient information. And the lamination
makes it hold up better, and makes it also even more noticeable among the
other paperwork and junk. Lamination is relatively cheap, too, I think --
and even more effective at saving it than plastic sleeves, purple folders,
etc, since the sheet doesn't come out of its protector while you are using it.
Anyone every seen anything like this? Someone want to hire a graphic
artist? This could be cool.
Elisheva Urbas, nyc
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Date: Fri, 7 Jan 2000 23:54:59 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: bf evolution
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In a message dated 1/7/0 11:22:06 PM, Rachel writes:
<< ....I felt certain clear through to my bones that I had done it =
before,...... >>
is it possible that a few decades of not using our bf skills/abilites, caused
these traits to be deleted from our genes? so, would our
re-education/training efforts get bf skill/ability back into our genes?
sleepy Deb
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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