So sorry about the wrong post earlier to Lactnet! Glad I didn't say
anything too embarrassing. Not that the words,
"This was great! Love, Brenda"
isn't embarrassing when it's sent by accident and around the world to 1600
people!
Those who know me will understand this kind of mess up is typical.
Apologies again,
Brenda Rockers
Conyers, GA
-----Original Message-----
From: Automatic digest processor <[log in to unmask]>
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Date: Saturday, March 11, 2000 12:04 AM
Subject: LACTNET Digest - 10 Mar 2000 (#2000-310)
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Date: Fri, 10 Mar 2000 22:49:27 -0700
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From: Patricia L Donley <[log in to unmask]>
Subject: Yeast
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Rob
I find that in these cases, Jack Newman's all purpose nipple ointment is
worth a try. Can't hurt, anyway...
Trish Donley RN ND IBCLC
Fort Defiance, AZ
(on the Navajo reservation)
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Date: Fri, 10 Mar 2000 22:48:09 -0700
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Rob
I wonder if baby is "done" after 5 minutes...
Also, I wonder if this baby would do better in a position where baby is
in control of feeding, like mother laying on her back with baby laying
across her. Maybe mom could get a better sense of baby's
needs/desires/cues in this position, and I don't think it would hurt if
reflux was the culprit.
Trish Donley RN ND IBCLC
Fort Defiance, AZ
(on the Navajo reservation)
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Date: Sat, 11 Mar 2000 02:59:47 -0500
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From: Darlene A Breed <[log in to unmask]>
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On Sat, 19 Feb 2000 13:18:43 -0800 Janet Hoover Malo <[log in to unmask]>
writes:
> >The nipple shield is an "easy answer" just as formula is. I'm not
> saying it
> >should never be used, but starting it in hospital?????????????
>
>
> As a hospital LC I have a question about this. I feel that if I let
> a baby
> go home that is not latching this baby has a high chance of being
> switched
> to formula. I would rather send the mom home with a shield, a pump
> and
> informed consent about the shield than take a chance of the losing
> breastfeeding all together. I agree that this is not ideal but in a
> hospital where we are not allowed to show the family finger or cup
> feeding
> it does seem the lesser of two evils.
>
> Janet Hoover Malo, LM, IBCLC
> Santa Cruz, CA
>
>
>
> mailto:[log in to unmask]
>
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Just my .02 worth. I agree that in this day and age where babies are
going home in 48 hours of less we are feeling a pressure to get this baby
feeding before going home. Babies are the best pump. A baby at the
breast with a shield and properly lated will actually transfer more milk
than a mother pumping and finger feeding or cup feeding. I know there is
a tremendous amount of controvery about this. Sometimes it is the only
answer to saving the breastfeeding. Then we can work with mothers to
eleminate the shield. I know not all of you agree with this, but I do
feel this is a forum that we can express our opinions and experience with
different cases. If everyone can be comfortable with the tools available
and work with the mother to make breastfeeding a good experience for her
and her baby, then what is the problem. You do need to follow the wt,
make sure mom knows how to contact you with questions, but let'd not
sacrafice the baby at the breast. Please, a shield can save a
breastfeeding mother often times.
Thank you,
Darlene Breed, BSN, RN, IBCLC
Coordinator, Milk Bank & Breastfeeding Center, Worcester, MA (USA)
Treasurer, Human Milk Bank Association of North America (HMBANA)
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Date: Sat, 11 Mar 2000 01:37:03 -0800
Reply-To: Lactation Information and Discussion
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From: Allison Norwood <[log in to unmask]>
Subject: Induced lactation
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I sent a question to Lactnet 3 - 4 days ago and have
not received any response. I will try again. I am
working with a mom who is adopting a baby. She has
been pumping for approximately 2 weeks and has not
experienced any or her own milk come in. She
breastfed her 11 year old without problems. She is
using fenugreek and SNS with every feed. She is
asking how long before her own milk might start to
come in? She is experiencing some tingling. TIA
Allison Norwood, RNC, MSN, IBCLC
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Date: Sat, 11 Mar 2000 09:24:58 +0200
Reply-To: Lactation Information and Discussion
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From: The Curries <[log in to unmask]>
Subject: Giftpacks
Our hospital gives out giftpacks which I was very unhappy about - no
formula but had a booklet in them with some very shaky information about
breastfeeding, in them. The secretary in the ward was sending our patients
names to the organization that distributes the packs. Going baby-friendly
the packs had to go somehow but my problem was solved - we had a take over
by another company and they felt that sending in the patients names to the
distribution company was a violation of the patient's confidentiality.
They have stopped them. I have no idea how it works in the States but
perhaps this could be a thought!
Sincerely,
Barbie Currie.RN RM White River, Mpumalanga, South Africa.
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Date: Fri, 10 Mar 2000 18:52:37 +0200
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From: Jean Ridler <[log in to unmask]>
Subject: Re: Induced lactation
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Valarie said:
" I question the use of drugs to induce lactation. I question the use of
drugs not because I think it doesn't work(I don't know, are there studies on
this in regard to induced lactation?) I question their use because of what
that may mean to the mother's understanding of milk production."
Just an interesting tidbit - A doctor friend of mine (who is also a LLL
Leader) has helped a few women induce lactation and her observation has been
that those women with a *medical* background could not do it without drugs,
whereas other women could! What does this say?
Regards
Jean Ridler RN RM IBCLC
Cape Town, South Africa
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Date: Sat, 11 Mar 2000 11:06:24 +0100
Reply-To: Lactation Information and Discussion
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From: "A. Bon" <[log in to unmask]>
Subject: Re: From the English version Numico webpage
Comments: cc: [log in to unmask]
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Kathy D. writes: <<<
The Dutch newspaper article makes it sound like the company is making
bizarre and wild claims. I wonder if this is just journalistic "hype".
Certainly the web page, while claiming to have a product better than
conventional formulas, does not say they have copied human milk. Hmmmm . .
>>>
Indeed, I noticed the same. The article in the newspaper was about the
annual presentation of the economical report of the compagny. From the
article in the newspaper (that is a very much respected newspaper, usually
it doesn't spread lies and gossip) it seemed as if the director had said:
"we've made an exact copy of human milk", "the scientific proof is almost
there", and "we will bring this milk to consumers via family docters and
via internet". This is both against the Dutch law, so I was already very
surprised. If he has said this, we do have prove he does break the
WHO-code, or at least has plans to do so. They deny they do break the Code.
I wish someone of 'us' was there to take notes of what was actually said.
regards,
Annelies Bon
Lay counsellor of the Dutch bf organization "Borstvoeding Natuurlijk"
Breastfeeding resources http://utopia.knoware.nl.users/abon/bfbronnen.htm
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Date: Sat, 11 Mar 2000 11:11:58 +0100
Reply-To: Lactation Information and Discussion
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From: "A. Bon" <[log in to unmask]>
Subject: Re: From the English version Numico webpage
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sorry I forgot to add a thing:
from the Numico page:
> Up to 50% of all babies fed by infant formula suffer from minor digestive
problems,
> such as colic, cramps, flatulence and constipation. These are usually
caused by
> a transient immaturity of the intestinal system and frequently require
the
> intervention of a health professional. To help provide digestive comfort
and a
> settled baby Numico Research has developed this product, based on three
> Numico patent applications. Clinical trials showed a significant
reduction
of the
> overall symptoms of digestive discomfort.
the reseach this text refers to is most probably the research that is done
in Nijmegen, in the Netherlands. This research has recently started, and
there are no results yet.
The recruitment of the subjects in this research was done unethically, and
a complaint is filed by the IBFAN group in the Netherlands.
regards,
Annelies Bon
Lay counsellor of the Dutch bf organization "Borstvoeding Natuurlijk"
Breastfeeding resources http://utopia.knoware.nl.users/abon/bfbronnen.htm
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Date: Sat, 11 Mar 2000 02:13:06 -0800
Reply-To: Lactation Information and Discussion
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From: Joan Edelstein <[log in to unmask]>
Subject: Re: Photos
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Unfortunately, photo printing places come under varying reporting laws
including child pornography (this is in no way to defend the situation).
So it mostly depends on where you bring the photos in terms of how they
interpret what they're allowed to do since they worry about their own
liability. When I was breastfeeding and taking in my photos I worried,
but had no problems, as it turned out. Then there are some adorable
photos of 6 year olds naked from the waist down. I also worried but,
again, no problem.
I totally agree that you shouldn't have any difficulty in getting these
on floppies. Is there a company you usually use for your photos with
BACE or NMC?
Good luck!!!
Joan
ps - I wouldn't mind seeing it on tv or in newspapers either - I assume
there are no tassels hanging off the breasts :-)
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Date: Sat, 11 Mar 2000 07:25:07 EST
Reply-To: Lactation Information and Discussion
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From: "Valerie W. McClain, IBCLC" <[log in to unmask]>
Subject: Re: From the English Version Numico webpage
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I would bet that Numico is selling genetically engineered baby milk. My
notes from January when the PPL Therapeutics company announced the news of
this new milk developed from their transgenic bovine program were that the
two companies involved were Wyth and Nutricia(is Nutricia related to Numico?)
I don't think many people realize that a human milk component was patented
in the US--John Hopkins University. To see
http://www.med.jhu.edu/otl/9530.html
That patenting seems to be the open door in which baby milk companies around
the world are using to get a better share of the market. The sad thing is it
is the infants of the world who have become the guinea pigs to this grand
experiment. That they are not announcing that it is gentically engineered is
understandable. It seems rather amazing that one can patent a human milk
component but I guess anything is possible in the US. Valerie W. McClain,
IBCLC
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Date: Sat, 11 Mar 2000 07:36:16 EST
Reply-To: Lactation Information and Discussion
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From: "Valerie W. McClain, IBCLC" <[log in to unmask]>
Subject: Nutricia is Numico
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Nutricia is Numico. Nutricia became Numico January 15th 1998. So it most
definitely is genetically engineered milk. So I guess they may be able to
say that it is close to human milk. Valerie W. McClain, IBCLC
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Date: Sat, 11 Mar 2000 13:56:27 +0100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: From the English version Numico webpage
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> Kathleen wrote: The Dutch newspaper article makes it sound like the company is
making
> bizarre and wild claims. I wonder if this is just journalistic "hype".
> Certainly the web page, while claiming to have a product better than
> conventional formulas, does not say they have copied human milk. Hmmmm . .
> . . . Newspaper and science-for-the-public magazines often exaggerate and
> make things more dramatic to try to generate interest. The same way every
> new fossil find in Africa is going to "Force anthropologists to completely
> rethink human evolution." Hardly.
Yes, you are right Kathleen. But it also is thru that the most vulnarable group
(expectant and new moms) often do not read all of the message, but merely are
head-hunting the papers. They are the ones Numico targets on. They are the ones
that will think why to bother with breastfeeding now that formula really is as
good as breastmilk.
Also note in the article you shared with us:
> quick relief of
> symptoms and a natural intestinal flora with soft stools (such effects are
found in
> breast fed babies).
and:
> Specific fats as found in breast milk
They do equal their formula with human milk here, if not in exact words then in
intention.
Some quotes from the newspaper article (frontpage)
Title: Numico: kopy of mother's milk
''We imitated nature,'' with these words topman van der Wielen of Numico
characterised the new babyfood of his company. At the presentation of the
yearresults of his concern v.d. Wielen claimed that Numico (...) made an exact
copy of human milk. (...)
On page 7 (economic news!) a 4column article opens: The nutrition company Numico
succeeded to make an exact kopy of human milk with natural ingredients. (...)
...powdered mother's milk ...
Then the article continues to describe the *very nice progress* Numico has made
in the food and food supplements market overall, but that the babyfood segment
keeps coming behind a bit, but that this new product certainly will lift it,
along with the follow-up milks.
Another quote from teh website article:
> Up to 50% of all babies fed by infant formula suffer from minor digestive
problems,
> such as colic, cramps, flatulence and constipation. These are usually caused
by
> a transient immaturity of the intestinal system
Ofcourse this is putting people on the wrong leg, while it should read:
''caused by the premature introduction of other foods than breastmilk.'' The
intestinal system is not in any form immature, it is exactly as it should be in
a newborn up to the first half year of live. By then it has not matured (as
opposed to immaturity), but rather transitioned to another stage, that of
digesting other foods then mother's milk. What they say is not just a literairy
freedom, but is deliberately giving false information with the intention to get
better themselves. Other words for that practise are lying or fraude.
They also ''forget'' to mention that breastfeeding is more than giving one food
instead of onother and that milk of mammals is designed especially for the
young/babies of the species to meet their nutritional as well as their health
needs (protection against infections and illnesses of the species concerned).
They don't mention that, while that's a factor they never will be able to put in
whatever great product they invent, nor can they substitute the special gift
mothers give to their babies *and* babies give to their mothers by offering and
accepting each others' bodies and love!
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
http://www.users.skynet.be/eurolac
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Date: Sat, 11 Mar 2000 14:03:03 +0100
Reply-To: Lactation Information and Discussion
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: Powdered blood?
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> What? You want HUMAN blood after your surgery/car accident? Don't be silly.
> Cow's blood is just as good.
>
> Jan B.
How about this one:
Why carry out your full pregnancy and be fat and ugly: get your baby out and
into the isolator. Ours is just as good as your own womb. Have your foetus have
a womb with a view!
Better to laugh than to cry, ain't it folks :-)
Gonneke van Veldhuizen
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Date: Sat, 11 Mar 2000 14:21:54 +0100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: Induced lactation
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> I sent a question to Lactnet 3 - 4 days ago and have
> not received any response. I will try again. I am
> working with a mom who is adopting a baby. She has
> been pumping for approximately 2 weeks and has not
> experienced any or her own milk come in. She
> breastfed her 11 year old without problems. She is
> using fenugreek and SNS with every feed. She is
> asking how long before her own milk might start to
> come in? She is experiencing some tingling. TIA
>
> Allison Norwood, RNC, MSN, IBCLC
> [log in to unmask]
Allison,
Is this mom going to adopt or is the baby there already? (''who is adopting a
baby'').
Maybe the milk is there already but doesn't ''want'' to come out; moms can feel
very stressed to produce milk and stop it from flowing by trying so hard.
I suppose she is double pumping with a hospital grade electric pump? What I've
found to work to have the milk come is:
- Use all kinds of massages the mother feels good about (her own interpretation
of how she feels about the massage is the key to this!), maybe she will need
firm massaging or maybe just efflleurage (very light, caressing, tingling
massaging).
- Apply heat at the level the mom appreciates most (again like in massage, her
own interpretation matters) as often as she likes, but in all cases ab. 15
minutes before pumping or breastfeeding.
- Have mom accept that it is not that important to have milk; she can use donor
milk or ABM in a nursing system while having the baby at breast. When she lets
go of the pressure to produce milk and instead focusses on being the mom to this
baby, experiencing lots of skincontact, perhaps some co-bathing, she may at some
point notice to have milk when she least expects it to be there. it can also
have to do with getting to know and love this special child and recognising it
as her own. Once she accepts this in her head and heart, her body will follow.
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
http://www.users.skynet.be/eurolac
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Date: Sat, 11 Mar 2000 08:23:57 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Janet Vandenberg <[log in to unmask]>
Subject: videos for staff education
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I would like to know if anyone who has seen the Chele Marmet video:
Breastfeeding Your Baby: Positioning
could comment on the positioning style used in this video. Is this a
chin touching, nose away, cross-cradle demo? Would you recommend it for
staff education? For parent education?
I have the VIDA "How to" video. It is great. But I am looking one
that is very detailed on positioning and latch to reinforce this message
to staff. Any thoughts on other videos?
Thank you,
Janet Vandenberg RN, BScN, IBCLC
Public Health Nurse
Newmarket, Ontario, Canada
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Date: Sat, 11 Mar 2000 14:36:23 +0100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "A. Bon" <[log in to unmask]>
Subject: Re: From the English Version Numico webpage
MIME-Version: 1.0
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> I would bet that Numico is selling genetically engineered baby milk. My
> notes from January when the PPL Therapeutics company announced the news
of
> this new milk developed from their transgenic bovine program were that
the
> two companies involved were Wyth and Nutricia(is Nutricia related to
Numico?)
yes, Numico is derived from Nutricia, Milupa and Cow's & Gate.
regards,
Annelies Bon
Lay counsellor of the Dutch bf organization "Borstvoeding Natuurlijk"
Breastfeeding resources http://utopia.knoware.nl.users/abon/bfbronnen.htm
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Date: Sat, 11 Mar 2000 09:41:48 EST
Reply-To: Lactation Information and Discussion
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From: "Valerie W. McClain, IBCLC" <[log in to unmask]>
Subject: Numico's claims
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Numico's claims present a host of problems. The patent of the human milk
component(from which this company can make these claims) is described as a
anti-diarrheic product, an anti-rotaviral agent. This component is described
as an anti-rotaviral agent such as human defatted fat globule membranes, the
human milk macromolecuilar fraction, the milk mucin complex, the 46 KD
apparent MW glycoprotein, or mixtures thereof, and optimally skim milk, curd,
and or whey. Notice the "such as" which means to me that they are not
necessarily using human milk. Product usage is for infants and children,
travelers, and immundeficient persons, including HIV positive and transplant
patients.
I have a feeling this may be a court battle in the making because they can
claim its closeness to human milk. How will we, breastfeeding advocates,
respond? They, the formula companies aren't lying. The issues are about
biotechnology and how what people are willing to allow in the pursuit of new
products and markets. Valerie W. McClain, IBCLC
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Date: Sat, 11 Mar 2000 09:46:58 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Susan Keith-Hergert <[log in to unmask]>
Subject: Re: skills checklist/ public heath nurses
Comments: cc: [log in to unmask]
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Have you seen the Breastfeeding Triage Tool put out by Seattle -King County
Department of Public Health in 1996? It is not a checklist but is a very nice
place to start for PH nurses as it addresses their concerns from where they are.
It can be ordered by calling 206-296-4672 or by faxing 206-296-4679.
I have no investment in this booklet, just think it is good for PH RN's.
Susan
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Date: Sat, 11 Mar 2000 07:30:36 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Rowena Tucker <[log in to unmask]>
Subject: yeast
Comments: To: [log in to unmask]
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Dear Dr. Cordes, I read your post on Lactnet about the
woman with continued deep breast pain post treatment
with diflucan. If I remember correctly, there are
resistant strains emerging. Alternatively, she could
be relapsing. Being "run-down" (I know, not very
medical) is associated with becoming infected in the
first place. Is she anemic? Is she eating especially
well (to support healing) and/or taking a vitamin
supplement (not prenatal vitamins)? It also occurs to
me that many woman who have had yeast develop milk
blisters (no specific association published that I am
aware of-just my experience). These can be very tiny.
Any sign of those? These are painful *WAY* beyond
their innocuous appearance, and the symptoms are
similar to those of a deep yeast infection. Just some
thoughts.
Sincerely,
Rowena Tucker PA, IBCLC
Texas
mailto:[log in to unmask]
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Date: Sat, 11 Mar 2000 10:41:55 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Alicia <[log in to unmask]>
Subject: Singulair used intranasally
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I have a mom who's physician is interested on putting her on 5-10mg
Singulair (montelukast sodium) dissolved in 1.5 fl. oz. of normal
saline 3 TID in each nostril.
The mom has a bad allergy to tree pollen and mold which causes asthma
or asthma-like symptoms (not a good thing to have here in Kentucky -
I'm having the same problems ;->). Her child is about 2 yo and
breastfeeding.
Anyway, I've looked it up in Hale's MMM 1999, but, this drug is
usually used orally and there is no info on using it intransally.
From what I understand, there is or was a clinical trial on using
Singulair intranasally and this mom seems to be a good candidate to
use this drug this way.
I'd like some info that I can pass on to her, so that she can share
it with her physician.
Thanks,
Alicia Rudin, LLLL in the Bluegrass (Lexington, KY)
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Date: Sat, 11 Mar 2000 16:00:08 +0000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: heather <[log in to unmask]>
Subject: Re: Numico's claims
In-Reply-To: <[log in to unmask]>
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Valerie asks:
>I have a feeling this may be a court battle in the making because they can
>claim its closeness to human milk. How will we, breastfeeding advocates,
>respond? They, the formula companies aren't lying. The issues are about
>biotechnology and how what people are willing to allow in the pursuit of new
>products and markets. Valerie W. McClain, IBCLC
This whole issue shows how it's never enough to proclaim breast milk and
breastfeeding as a health issue - though of course it is. But if it is
*only* a health issue, or even *primarily* a health issue, some clever
boffn can come along and say 'ha! we have an identical product!'
Breastfeeding is a right, of a mother and baby. It is every mother's right
to choose to do it, and to expect the social and emotional and financial
support she needs in order to make it happy. We don't have to prove it's
'better' - it's not a consumer product, but a part of a relationship which
we have a right to.
Of course, nothing made in a lab can ever be identical to the living
ever-changing fluid of an individual mother's own body and taken by her
individual baby in their individual circumstances. We have a hard time
'proving' that, though.
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
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Date: Sat, 11 Mar 2000 11:16:19 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: Re: Induced lactation
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In the course of working with about 20+ moms on induced lactation, some of
whom had been pregnant and previously lactated, some of whom had never been
pregnant nor lactated previously, the average duration before actually seeing
any milk was about two months. This was using stimulation from an EBP,
hospital grade, and sometimes Dad, with no meds. Some used fenugreek after
first droplets arrived. Some had copious milk supplies, some had modest
supplies - regardless of interventions after the milk came in. Seems the mom
of whom you speak is expecting abit too much too soon.
Regards,
Gretchen Andrews, BA, IBCLC
private practice, Redlands, CA, USA
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Date: Sat, 11 Mar 2000 11:11:42 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Pam Easterday <[log in to unmask]>
Subject: Allison Norwood about adoptive nursing
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I answered Allison's question about adoptive nursing but it bounced back.
Maybe a whole bunch did. Not all of us want to dance in public.
A friend had tender nipples and the first drips of milk after two weeks of
just the baby at the breast with a supplemental nurser. I know an adoptive
mom who had milk after two days of pumping.
I would cheer the tingling and any other changes as great news.
Pam Easterday LLLL Ohio
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Date: Sat, 11 Mar 2000 12:27:44 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Jeanette F. Panchula" <[log in to unmask]>
Subject: when to start what?
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The frustration of a mom whose milk is not fully meeting the needs of the=
baby is often matched by my frustration in decsion-making:
1. (the easy part) evaluate feeding effectiveness, breast, mouth, etc....=
BUT NOW - =
For example (this is not one case, but an example of repeated cases I hav=
e
had to deal with in the last year).
Baby is 2 weeks old. Has not been breastfeeding effectively, and I have
now corrected positioning and taught moms breast compressions.
Mom was not instructed to breastfeed on cue - she was told to feed baby
every 3 hours, and to "complete" every feeding for the first three days
with 2 oz of formula (per Pediatrician's order). =
Baby is now taking 3 ounces at every feed, willing to stay at the breast
for 3-4 minutes, so I can switch to an SNS, have her pump/hand express
after feeds to increase production.
However, I'm finding that moms don't do this - they get frustrated with t=
he
SNS, are too tired or busy with other kids to pump/express after every
feeding. Perhaps they'll do it 2-3 times a day if I'm lucky.
Physicians I've worked with have recommended the use of Reglan EARLY in
this process, which will raise prolactin levels closer to the time when i=
t
would have naturally been up. =
But others of you recommend avoiding it at all costs and using fennugreek=
,
etc.
Could we have a discussion on this or has it been hashed over recently?
[I know I need to work on the hospital information and the MD information=
,
and in my current position I can work on it - but change of that nature i=
s
slow and I need to help these moms NOW.]
Jeanette Panchula, BSW, RN, IBCLC
Vacaville, CA
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Date: Sat, 11 Mar 2000 12:46:50 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: newman <[log in to unmask]>
Subject: montelukast
Comments: cc: [log in to unmask]
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If this drug is unlikely to get into the milk in any significant amounts
after oral administration, it is likely to get into the milk in even smaller
amounts after intranasal administration.
Never assume a drug is contraindicated until proved otherwise. Assume it is
okay until proved otherwise. The risks of not breastfeeding are too great.
In this case we have a drug which is 99% protein bound. This is a good
theoretical basis on which to say it's okay for breastfeeding mothers, and
this does not change if the drug is given intranasally, IV or into the left
ventricle of the heart.
Jack Newman, MD, FRCPC
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Date: Sat, 11 Mar 2000 11:03:30 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Barbara Wilson-Clay <[log in to unmask]>
Organization: Austin Lactation Associates
Subject: photos
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I have developed clinical photographs at groc. stores and photo/camera shops
for years with no problems. Once or twice I was quest. at the grocery, but
I adopt a haughty attitude and describe them as "medical" photos and then
everyone is very nice about it. I, too, was turned down for getting
slides transferred to floppy disks, tho no letter of explanation. It may be
you'd have better luck going thru a reputable camera shop and talking to
them about the nature of the photos in advance, so they can assure the lab
it isn't porn. It may be an expensive option, but you might want to
consider buying a slide scanner and a CD burner and putting everything on
CD. You still have to get the film developed, but you can scan the film or
slides thru the scanner and create digital images from your non-digital
camera shots. I just bought this equipment because Kay Hoover and I are
putting the images from the Breastfeeding Atlas on CDs. Don't call me about
this because it won't be ready for a while, but the resolution is awesome!
Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com
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Date: Sat, 11 Mar 2000 11:50:11 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Barbara Wilson-Clay <[log in to unmask]>
Organization: Austin Lactation Associates
Subject: nipple shields and herbs -- long
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I am interested to observe the continual outcry against the possibly
uninformed use
of nipple shields and the lack of outcry against the possibly uninformed
use of herbs to
"treat" mothers. While indiscriminant and un-informed use of ANY type of
equipment is UNETHICAL, there is acceptance amongst many serious clinicians
that shields have a limited but appropriate usefulness in managing certain
specific conditions in nursing dyads. Many serious clinicians also accept
there are uses for herbs (or vitamins) in the care of postpartum dyads,
but I submit that the casual and uninformed use of herbs
can be unethical and pose risks. I am concerned that there is so little
discussion of this in the
enthusiasm of the recent herbal discussions.
The fact is , herbs can be benign or neutral, but
they have their dangers, too. They are compounded in numerous ways, are
called by different names in different areas, and often are of uncertain
purity. Because they are sold as nutritionals rather than pharmaceuticals,
they are unregulated
in terms of dosage, mold content, expiration date. Depending on how they
are prepared their
dosage strength will vary.
Further, they are often dispensed by people who have no clue as to
dosage, interactivity with other drugs or conditions, and by those who have
no knowledge of toxic reactions. I submit that it is dangerous for
lactation consultants to uncritically embrace and promote therapies that are
as
un-researched as most herbal treatments tend to be, and to casually dose
people just because they heard about something on the net or in an herb
book.
I don't dismiss herbal remedies. I use aloe on burns, chamomile tea
when I have an upset stomach, gentian violet on candidal infections,
and I read the serious literature on herbs
with an open mind. I welcome clinical trials on efficacy and
applaud the people who publish their observations
so we all can benefit from their experience. I believe that plants/herbs
are medicine with un-tapped potential that should be studied and used when
appropriate.
But it requires some sober consideration that LCs may be going so far
beyond their scope of practice on the issue of recommending herbal
medicines -- esp. when not specifically educated to do so. I do not
consider
attending one workshop or reading one article sufficient.
Let me tell you a frightening story that involves herbs and vitamins used as
medicine. I have a client who is a dentist. She has allergic disease
(eczema) and her first and second daughters had early outbreaks of atopic
dermatitis/eczema. Upon the urgings of a naturopath, my client began taking
mega-doses of Vit. A and began giving her 6 mo old infant oral borage oil
and oral cod-liver oil. She called me to tell me that each time she tried
this, the baby would break out in skin lesions that looked like chicken pox.
A dematologist called it a "viral exanthum" -- or else some sort of
non-specific failure of the immune system. She hadn't told him about the
supplements. I looked up borage in one of
Ruth Lawrence's herb monographs, and she described potential for "toxicity",
and Vit A certainly has toxic potential.
This naturopath prob. knew nothing about breastfeeding, transfer of drugs
into milk, and never even bothered to look it up. And he appeared to
operate on the philosophy that if a little is good, a lot is better
irregardless of the body weight of his small client. Yet Hale states:
"The overdose of Vit. A is extremely dangerous and adults should never
exceed 5000 units/day. DO NOT [his emphasis] use maternal doses> 5000 units
per day...Infants do not generally require vitamin A supplements" because
"Mature human milk is rich in retinol and contains 750 ug/Liter (2800
units)." I shudder to think how much vit. A this tiny body was receiving.
I would urge restraint in our enthusiasm to
uncritically embrace ideas, and temper this with an examination of the first
rule
of practice: Do No Harm.
This applies to the use of herbs and viatmins as well as of any type of
equipment.
Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com
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Date: Sat, 11 Mar 2000 20:31:38 +0200
Reply-To: Lactation Information and Discussion
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From: Yael Wyshogrod <[log in to unmask]>
Subject: Re: videos for staff education
Comments: cc: Janet Vandenberg <[log in to unmask]>
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I use the Chele Marmet video "breastfeeding your baby : positioning" in
breastfeeding classes for parent education.
This video shows the cradle hold, and the clutch (football) hold, in detail.
It does not show the cross cradle hold nor the chin touch, nose away
(assymetrical) latch, but it does show and emphasize good technique for
offering the breast and eliciting rooting with mouth wide open, and I find
this useful.
I've recieved feedback that parents "remembered the video" seen in prenatal
classes and that it helped them in the early days postpartum.
However, since I have found through my own experience that the assymetrical
latch works better (usually with cross cradle hold), I demonstrate these and
have the parents practice with dolls.
I haven't seen many of the other videos available but I have found that this
one is quite good and in combination with instructing the assymetrical latch
and cross cradle hold, it works well and parents retain much of what they
saw.
Yael Wyshogrod IBCLC
Rechovot, Israel
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Date: Sat, 11 Mar 2000 19:13:39 -0000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Magda Sachs <[log in to unmask]>
Subject: breastmilk
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Heather you say:
>Breastfeeding is a right, of a mother and baby. It is every mother's right
to choose to do it, and to expect the social and emotional and financial
support she needs in order to make it happy. We don't have to prove it's
'better' - it's not a consumer product, but a part of a relationship which
we have a right to.<
I agree with you. But the situation in the world today is that we have the
challenge of 'proving' not that breastmilk is better, but that it is safe.
The UK government official policy -- same in US -- is to discourage or even
stop women who have tested HIV+ from breastfeeding. The language of the UK
government guidance to health professionals is about 'women who insist on
breastfeeding' and 'women who cannot avoid breastfeeding'.
WHO/UNICEF discuss the effects of 'spillover' if formula is promoted for
women who are HIV+ -- spillover is a leaking fo the specific message from
women who are that group to wider society. I believe that this is a huge
concern, not just in developing nations.
Numico and their product (notice Valerie found that it is recommended for
HIV??) is one prong of the companies. Fostering distrust of breastmilk --
and where better than in the area of HIV??-- is another.
Has everyone noticed the tiny Minerva item in the BMJ which commented on the
Ndauti study in March JAMA? Seen the concluding sentence? "only complete
avoidance of breast feeding will reduce the risk." (If you have read the
paper, you will know that this conclusion is not justified by the JAMA
results).
It is going to be hard to stay on the ground of the human relationship, when
the opposition has defined the debate not as one of competing health gains
but as a matter of restricting the transfer of a poisoned body fluid.
Here's hoping that Anna Coutsoudis's further results are published soon and
that the BMJ finally reports on *them*.
Magda Sachs
Breastfeeding Supporter, BfN, UK
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Date: Sat, 11 Mar 2000 14:26:04 EST
Reply-To: Lactation Information and Discussion
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From: Judi Hall <[log in to unmask]>
Subject: Re: herbs and breastfeeding
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As a hospital LC I frequently recommend Moms consider fenugreek. We give
them literature about herbs as galactagogs. We checked with one of the
neonatologists who is from the middle east if he had any concerns for babies,
especially premies. He told us that fenugreek is a normal part of the Middle
Eastern diet and there was no concern for the baby. I have many moms who
swear by it.
Judi Hall
RNC, IBCLC
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Date: Sat, 11 Mar 2000 12:01:38 -0800
Reply-To: Lactation Information and Discussion
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From: Allison Norwood <[log in to unmask]>
Subject: Induced Lac. Response
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Thanks for responding. The mom that I am working with
is currently out of state with the adoption so we are
working via email. She is excited just at the
possibility of being able to nurse and the baby is
aggressive at breast. She is enjoying just the thought
and experience she has had so far but it has been hard
for her to be flying and trying to use the SNS etc.
She is pleased that her new daughter is aggressive at
the breast but just asked the question and most of
what I have read is very broad. She does understand
this and is willing to continue working with bf. It
will be easier when I can meet with her. Thanks again
for everyones support and knowledge.
Allison Norwood, RNC, MSN, IBCLC
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Date: Sat, 11 Mar 2000 21:07:34 +0100
Reply-To: Lactation Information and Discussion
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From: Rachel e-mail <[log in to unmask]>
Subject: Numico and marketing tactics
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From the Numico article:
"Up to 50% of all babies fed by infant formula suffer from minor =
digestive
problems, such as colic, cramps, flatulence and constipation. These are =
usually
caused by a transient immaturity of the intestinal system and frequently =
require
the intervention of a health professional."
And yet they have no trouble getting people to buy the stuff! Does =
anyone have data on the proportion of BF babies who suffer from colic, =
cramps, flatulence and constipation?
I am impressed that members of the industry are already using this in =
their marketing, when only weeks ago the previous generation of ABMs =
were as close as you could get to mothers' milk, really only =
distinguishable from the real thing by the container !
I am again strongly reminded of my precociously politically correct =
son's attempt to explain to his older sister what XXX brand ABM was. =
She was so sheltered she didn't know such products existed, and he said, =
"You know, it's one of those mother's milk forgeries!"
Rachel [log in to unmask]
Kristiansand, Norway where it is clear and bright with just a hint of =
new slush on the ground. Sets off the crocuses most delightfully!
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Date: Sat, 11 Mar 2000 16:20:05 EST
Reply-To: Lactation Information and Discussion
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From: Helen M Woodman <[log in to unmask]>
Subject: Mother's Milk
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Great story in this week's eBMJ at
http://www.bmj.com/cgi/content/full/320/7236/691
Helen Woodman, National Childbirth Trust Breastfeeding Counsellor,
Storrington, West Sussex UK. Start at the top - NCT Scotland site
www.the-nct.org.uk Have you visited the NCT UK site? www.nct-online.org
Support NCT as you shop with NCT Maternity Sales www.nctms.co.uk
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Date: Sat, 11 Mar 2000 17:09:52 EST
Reply-To: Lactation Information and Discussion
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From: Ann Perry <[log in to unmask]>
Subject: engorgement and cabage
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Ideally avoiding engorgement is the best approach but this is not the real
world, so we need to think about what is going on inside the breast and how
to relieve the symptoms ASAP.
Engorgement is not just the breast over full of milk, they are also congested
with lymph fluid and blood. With this in mind, frequent emptying of the
breast will not eliminate the problem in the first 24 hours or more. The
body needs encouragement to empty the extra lymph fluid and slow down the
blood flow to only what the breast need to make milk.
With this in mind the approach to treat engorgement is two fold: frequent
emptying of the breast and cold compacts to reduce the edema. The use of
cabbage as the cold compact has been antidotally shown to be very effective.
What I have a problem with the JHL article on comparing chilled leaves to
room temperature, is that cabbage naturally is cool to the touch, in the frig
or out. Cabbage are easier to use than cold packs because you don't have to
hold them next to the breast. I tell the moms to remove the leaves once they
start to wilt, so there is no need to watch a clock. I do not approach the
use of cabbage because of any chemical wonder but the cold aspect. I also
advise moms to take Ibuprofen as an anti-inflammatory and pain relief for
12-24 hours. I tell moms to avoid heat through all of this, if they need
help to get the milk to flow I prefer gentle massage, if they do use heat it
is very limited just prior to the feeding.
Ann Perry RN IBCLC
Boston, Mass
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Date: Sat, 11 Mar 2000 17:03:22 -0500
Reply-To: Lactation Information and Discussion
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From: Kathleen Bruce <[log in to unmask]>
Subject: Re: JOURNAL CLUB #2
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From Catherine Watson Genna, IBCLC, here is the start of our second
discussion for Journal Club. Please feel free to jump in and start the
discussion of this article, and feel free to bring in the companion article
by Lisa Amir MD, et al, as well, from the same JHL issue.
Kathleen
"The Treatment of Staphyloccocus Aureus Infected Sore Nipples: A
Randomized Comparative Study." by Verity Livingtone, MBBS, FCFP, IBCLC
and L. Judy Stringer, MBBS, MRCGP, IBCLC, Journal of Human Lactation,
15(3), 1999.
The authors suspected a link between delayed healing of cracked nipples
and Staph aureus infection. Women presenting with cracked nipples, but
without mastitis, had their nipple lesions cultured. Those positive
for Staph aureus were randomized to one of four treatment groups:
- individualized bf technique assistance from an LC.
- topical mupiricin ointment (Bactroban) and bf technique assistance.
- topical fusidic acid ointment and bf technique assistance.
- beta lactamase resistant systemic antibiotics (dicloxacillin or
erythromycin 500mg/qid/10d) and bf technique assistance.
Women were re-evaluated in 7 days, and nipples assessed as
better/resolved, no change, and worse based on pain and skin
appearance. Any cellulitis, mastitis, or fever was considered a
treatment failure, and oral antibiotics were prescribed.
Results: a large proportion of each of the non-systemic treatments
failed to improve, and a significant proportion progressed to mastitis.
79% of women in the oral antibiotic group improved and only 5%
worsened. Fusidic acid outperformed mupiricin, but only a minority of
women were improved in one week with both topical treatments. Optimal
technique alone showed improvement in only 9% of women in this study,
35% of them worsened over one week, and 30% progressed to mastitis. In
all, 25% of mothers treated non-systemically progressed to mastitis, but
only 5% of those given oral antibiotics developed mastitis. The authors
recommend that sore, cracked nipples be clinically diagnosed as impetigo
vulgaris, and be treated with systemic antibiotics for a minimum of 10
days until the skin is fully healed, while improving breastfeeding
technique to prevent added trauma or friction to the nippples.
Other interesting points:
- 5 women in this study reported deep, radiating, burning breast pain
and episodic vasospasm of the nipples, unrelated to immediate sucking.
The authors attribute this to both repetitive gumming of the nipple and
the S. aureus infection.
- The advice to not use soap on the nipples contradicts hygeinic
adjuncts to impetigo treatment.
- 17% of the moms with S. aureus infections had poorly graspable
nipples.
- 10% of their infants had tongue tie, and 12% had significant
retrognathia.
--
Catherine Watson Genna, IBCLC New York City mailto:[log in to unmask]
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Date: Sat, 11 Mar 2000 17:29:57 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
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Lisa:
I think that it is interesting that VL says that 43& had sore cracked
nipples during thier postpartum stay - does this suggest that they contracted
staph in the hospital?
The one case I saw that was "diagnosed" as staph ( no culture done) was a
raised "sore" on the nipple. It was not open nore did it ooze or drain - the
picture was published by Birth Issues { 6:3 1997) the mother did not have a
crack that she recalled prior to the appearance of the "sore".
Patricia
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Date: Sat, 11 Mar 2000 17:29:55 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Re: when to start what
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Jeanette:
as always you ask very thought provoking questions...
In my practice ( private) if I suspect lack of grandular strucure I will
recommend goats rue and more milk ( fenugreek, blessed thistle, red
raspberry, bararge or fennel) dropperful 3x a day.
.... I do not use pharmaceuticals.
Patricia
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Date: Sat, 11 Mar 2000 23:30:04 +0100
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: engorgement and cabage
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> Engorgement is not just the breast over full of milk, they are also congested
> with lymph fluid and blood. With this in mind, frequent emptying of the
> breast will not eliminate the problem in the first 24 hours or more. The
> body needs encouragement to empty the extra lymph fluid and slow down the
> blood flow to only what the breast need to make milk.
Ann Perry wrote:
> With this in mind the approach to treat engorgement is two fold: frequent
> emptying of the breast and cold compacts to reduce the edema.
snip
> I tell moms to avoid heat through all of this, if they need
> help to get the milk to flow I prefer gentle massage, if they do use heat it
> is very limited just prior to the feeding.
Strange isn't it, how two persons with the same profession can look from a
totally opposed angle at the same problem and both achieve good results.
I always stress to avoid cold and to apply gentle warmth to any kind of plugs,
engorgement, infections and imlfammations. I warn that massaging a engorged
breast can be harmfull, while the tissues are so overstretched and tense.
My rationale for using heat and avoiding cold is that cold can cramp all vessels
(blood and milk routes and probably lymphe)and keep the fluids from flowing and
that warmth will make the fluids flow, relax the mother and help the processes
that take place inside and by the body to deal with the problem.
As for the exessive blood and lymphe: they will disappear soon after the reason
for being there is taken away, in other words when the overlaod of milk is
removed. Therefor I like to treat engorgement by removing as much milk as
possible at once (and only once) with a hospital grade double pump and after
that keeping them as empty as possible by frequent feedings.
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
http://www.users.skynet.be/eurolac
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Date: Sat, 11 Mar 2000 17:53:36 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Osteoporosis Update
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Hello Lactnetters,
I wanted to say thanks again to all who responded to my requests for
information on breastfeeding and osteoporosis. I have absorbed the shock of
having a lifelong disease and spent a great deal of time researching. The
pain has decreased sufficiently thanks to the help of family and friends who
have been here taking care of my home and baby while I sit still. I can walk
a little around the house. I am still fearful of further fractures.
Rose and I are still nursing. In fact, it is one of the few things I can s
till do which gives some sense of normalcy to life. I don't know how we
would ever manage if she were bottle-fed. After reviewing a great deal of
research I have decided that we are at the point, 5-6 months postpartum,
where my bone loss has already reached it's lowest point average of 3 to 9%.
We are beginning to add solids. Having begun the weaning process bone
resorption should be turning around naturally. Research is clear that bone
density is restored post-lactation and with the return of menses, an average
of 1.1 to 1.9% increase over baseline, even in the case of a pregnancy before
complete weaning.
The endocrinologist requested a few labs, all of which turned out to be
normal. His plan of action is 1500 mg of calcium daily, Miacalcin Nasal
Spray, and Actonel (risedronate) as soon as FDA releases it for use in the
US. I am uncertain as to whether I want to use the risedronate since it is
such a new drug. I don't mind experimenting on myself so much, but I don't
want to experiment on the baby. Dr. Hale, is there any information yet on
safety of this drug while breastfeeding? What would be the advantage of
using it over Fosamax (alendronate sodium)? Follow-up with another bone
density test is not for a year.
I have also begun to use natural progesterone cream daily. This is an
alternative to estrogen therapy which is known to increase bone density
without the side effects and so far has not affected milk supply either. I am
using calcium supplements with, magnesium, manganese, copper, zinc,
phospoorus and boron. Boron in 3mg per day has been found to be significant
in building bone in conjunction with calcium. I am also using an herbal
calcium. I have added lots of calcium in the diet, especially greens since
there is some debate about the effectiveness of dairy calcium.
I still welcome any information you come across related to lactation,
osteoporosis, and treatments. La Leche League's PL Department has provided
me with some excellent information as well.
Judy Gutowski, IBCLC
typing with baby on my lap as with previous post on milk after stopping
breastfeeding - sorry for typo's
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Date: Sat, 11 Mar 2000 18:57:27 EST
Reply-To: Lactation Information and Discussion
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From: "Valerie W. McClain, IBCLC" <[log in to unmask]>
Subject: Re: breastmilk
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I believe Magda's comments in regard to breastfeeding and hiv, as well as
Heather's comments about a mother's and infant's right to breastfeed, are
important. I believe we, breastfeeding advocates, are standing on the edge
of a "new world." We have many choices in front of us. It is clear that our
beliefs in breastfeeding have been tested and will continue to be tested.
The only think I would add to Magda's post is that we all need a better
understanding of the CDC's decision to discourage breastfeeding in 1985. My
understanding is that it was based on Thiry et al 1985 and Ziegler et al
1985. Thiry et al is a letter to the Lancet relating the finding of hiv in
three samples of cell-free breastmilk from diagnosed hiv-positive women.
Ziegler et al is about 1 infant who was diagnosed hiv positive at 3 or 4
months of age. The mother breastfed the infant for 6 weeks. The mother had
had a c-section and required a blood transfusion. The CDC web site has this
1985 breastfeeding policy decision and these are the only "studies"
mentioned. The conclusion one is left with is that 4 cases are the basis of
this decision. Was this decision reviewed? Anyone know? If this decision
has never been reviewed, it can only make one wonder. Nduati in her recent
study in JAMA(March 2000) sites the CDC decision in 1985 as the standard for
all industrialized countries. A standard based on 4 cases and now being
pushed as a standard for the rest of the world. Fear closes the mind to many
ideas. Fear surrounds the issue of hiv and breastfeeding. I am hopeful that
we can collect our courage and open the light into this issue. Valerie W.
McClain, IBCLC
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Date: Sat, 11 Mar 2000 19:03:12 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Re: Grandmothers
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Hi,
Thinking about offering a class (either pre-or post-natal) for grandmothers of
breastfeeding babies. If any of you have given this type of class, I would
love
to hear the kinds of information you've included in your session.
Thanks so much for any input.
Tammy Arbeter - [log in to unmask]
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Date: Sat, 11 Mar 2000 22:33:49 EST
Reply-To: Lactation Information and Discussion
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From: Kermaline J Cotterman <[log in to unmask]>
Subject: Adoptive mom
Comments: To: [log in to unmask]
Allison,
I agree wholeheartedly with what Gonneke wrote:
< Use all kinds of massages the mother feels good about (her own
interpretation
of how she feels about the massage is the key to this!), maybe she will
need
firm massaging or maybe just efflleurage (very light, caressing, tingling
massaging).
- Apply heat at the level the mom appreciates most (again like in
massage, her
own interpretation matters) as often as she likes, but in all cases ab.
15
minutes before pumping or breastfeeding.
- Have mom accept that it is not that important to have milk; she can use
donor
milk or ABM in a nursing system while having the baby at breast. When she
lets
go of the pressure to produce milk and instead focusses on being the mom
to this
baby, experiencing lots of skincontact, perhaps some co-bathing, she may
at some
point notice to have milk when she least expects it to be there. it can
also
have to do with getting to know and love this special child and
recognising it
as her own. Once she accepts this in her head and heart, her body will
follow.>
I think we ought to place greater priority on the importance of
stimulating the MER before nursing or pumping to ALL moms, not just
adoptive moms.
I have been doing some serious reading in research texts with people
whose first expertise was veterinary medicine before they specialized in
lactation research. They emphasize strongly that the main force in
transfer of milk out of the glands is the MER in all other mammal
species.
So much of the cellular anatomy under the microscope and secretion
physiology is indistinguishable between the species, so I figure why
would the milk ejection reflex be any different in humans except that the
mother has the mental capacity to generate stress hormones about her
capability, which other mammals don't. (At least your client does not
have delivery interventions and edema to contend with!)
It is adrenalin caused by stress which constricts circulation to the the
pituitary, keeping it from secreting sufficient oxytocin (and probably
prolactin). It also interferes with the circulation to the mammary
tissue, which hinders the effectiveness of the MER. And of course, it is
the thoroughness of milk removal, starting from the glandular area, which
is essential for continued production.
So, once again, I agree with Gonneke about supportive reassurance on the
overall importance of the mothering actions, skin to skin, falling in
love with the baby as the main priority.
And to her suggestions about proactive stress management by relaxing
stimuli to condition the MER, I would add one thing. I have found it is
helpful to teach moms to do a minute or so of manual extraction (even if
no milk comes out) which often stimulates the nerves deep in the
nipple-areolar complex better than the pump does.
I wish all that is now known about adoptive nursing had been available to
me when we completed our family by adopting our 6th child 28 years ago.
Best wishes to her (and you)
Jean
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K. Jean Cotterman RNc, IBCLC
Dayton, Ohio USA
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Date: Sat, 11 Mar 2000 19:26:31 -0800
Reply-To: Lactation Information and Discussion
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From: Jan Aken <[log in to unmask]>
Subject: Photos
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when I have my pictures developed I will have prints and also C.D's. I have
kodak processing and I never have been questioned. But when I drop the film
off I will often say to the sales person that I am a nurse and work with
breastfeeding mothers and that I have several medical pictures on my roll of
film. I found having the pictures of a C.D. works very well when sharing
pictures with colleagues
Jan Aken RN Ibclc
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Date: Sat, 11 Mar 2000 21:56:35 -0600
Reply-To: Lactation Information and Discussion
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From: Jim & Winnie Mading <[log in to unmask]>
Subject: "Gift" packs
Comments: To: The Curries <[log in to unmask]>
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I'm beginning to feel a little like Pavlov's dog. As soon as I saw
the term "gift" pack I
wanted to jump in and say "SAMPLE pack". While I hope the time will
come that we can
convince the powers that be at our hospital to stop giving them out,
in the meantime I have
made it a point to try to get staff to change their termonology and
hopefully thereby their
thinking. Whenever I hear someone using the term "gift" I simply
say "sample" and if they
don't seem to know what I'm saying, I explain further. Most now
know my views and
when I hear that word all I have to do is say "What?" and they
immediately say something
like"Oh yeah, sample".
THEY ARE NOT GIFTS. They are advertising samples. Anything given
with the aim of
getting something in return does not warrant the name "gift". These
packages certainly
aren't given out with any altruistic motivation.
Unfortunately, the hospital "saves" around $18,000 per year in not
having to purchase
volu-feeds, nipples, etc. which they get "free" because they give
out the sample packs! This
is a tough obstacle to get past. We're trying to research all
Policies and Procedures to see
if we can find one about other types of samples and then we'll try
to get that applied to the
ABM stuff.
Winnie Mading, RNC, IBCLC who sometimes has to step back and look
not just at where I want to be but also how far we have come over
the years.
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Date: Sat, 11 Mar 2000 13:19:43 -0500
Reply-To: Lactation Information and Discussion
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From: Darlene A Breed <[log in to unmask]>
Subject: Re: Shields versus cups and finger feeds
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> meantime I
> think I'd rather let them bottle feed than start a shield before the
> milk is in.
> Why? I've never seen a baby effectively extract colostrum through a
> shield. If I
> were to start a shield at this stage...I'd be very concerned about
> the baby's
> hydration and the mom's supply. If I am going to use a shield
> anyway....why not
> use a bottle (like a Haberman, Avent...) and then work back to the
> breast with a
> shield once the supply is established with effective pumping?
> Susan Keith-Hergert RN, MS, CPN, IBCLC
> Mercy Health Partners
> Cincinnti, Ohio
Susan,
Just my .02 worth. As a hospital LC , I have seen babies transfer
colostrum from the breast many times with a shield (thin silicone type).
I do think the mother has to be instructed and shown how to latch the
infant properly. Instruction in Sx to look for indicating proper
hydration. The shield has saved breastfeeding many times for mothers I
have assisted. I also believe that having the baby attached to the
breast,,even with a shield , allows for the transfer of milk faster and
easier than pumping. At least the mother is holding the baby, baby is at
the breast.. Some mothers have a real problem with MER using a pump.
Some new mothers go home pumping and finger feeding or cup feeding find
it too stressful and so much work they stop breastfeeding and go to
formula. I have had babies that need only one or two feeds with a shield
and then go to breast after that. I also have a mother using the shield
use breast compression, thank you Dr.Jack.
We all have our techniques and every M/B dyad is unique. We have to make
the assessment and do what works for that M/B dyad.. It is too difficult
to make a blank statement about what we should or shouldn't do. When you
are the one with the patient. you are the expert. Bottles do not teach
an infant to suck correctly.
Thank you,
Darlene Breed, BSN, RN, IBCLC
Coordinator, Milk Bank & Breastfeeding Center, Worcester, MA (USA)
Treasurer, Human Milk Bank Association of North America (HMBANA)
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Date: Sun, 12 Mar 2000 01:11:11 -0500
Reply-To: Lactation Information and Discussion
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From: Jennie Elmaleh <[log in to unmask]>
Subject: hydrocephalus/hypotonia
Hello all,
A mother of a 19 month old boy with hydrocephalus (with shunt in place) and
hypotonia, called with the following- He is still mostly nursing, very
little solids. He weighs over 13 kg-(26 lbs) and is healthy, besides his
chronic condition.
The occupational therapist and the speech clinician who are supposed to
give this child therapy , have told the mom that the child has no
motivation to learn to feed himself or to speak because of his "constant"
nursing. They threatened not to continue treating him, that it is wasted
time, as long as he keeps on asking to nurse during the sessions. They also
told the mom that she must see a psychologist because it is "obvious" that
she (mom) is the one who wants to continue nursing, that she has some
problem. They said that this mom must "sever" herself from her baby in
order for him to move foward developmentally----!!!!! The mom is pretty
secure in her nursing relationship and feels that this is the one aspect
that is completely positive and secure and gives them both so much strength
and health- The mom herself doesn't ned to be convinced of the benefits of
bfdg her baby, but feels helpless confronting these "professionals" who are
supposed to be helping her to help her baby.
Can anyone help me find references specific to this situation- something
that talks specifically about the benefits of continued bfdg in babies with
hypotonia and hydrocephalus? I would like to be able to send it to these
two people. The baby's pediatrician is relatively supportive, saying that
it's okay to continue bfdg, but that the baby really should be eating "real
food" already. The mom cannot at this point change therapists because of
her medical insurance coverage and her living in a relatively small area,
far from other major cities.
Thanks for your help.
Jennie in Israel
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Date: Sun, 12 Mar 2000 01:38:21 EST
Reply-To: Lactation Information and Discussion
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From: Anne Merewood <[log in to unmask]>
Subject: Re: Formula samples
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When our hospital recently became Baby-Friendly, getting rid of free formula
was the biggest barrier we had to overcome.
One thing I would check into before throwing up hands in despair is the
ACTUAL cost of formula and formula products to the hospital. Where did that
$18,000 figure come from? Before we looked into the issue, the official story
was that our 1600 births per year hospital was using $70,000 of free formula
and formula company products. When we surveyed the real amounts used, by
counting bottles on the individual units (as opposed to relying on the free
products listed by the formula company) we came out with an estimate of
closer to $20,000. It was still a long process to get the formula paid for,
but hospital administrators were far more willing to negotiate around $20,000
that they were around $70,000...
Anne Merewood IBCLC
Director of Lactation Services
Boston Medical Center
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Date: Sun, 12 Mar 2000 01:08:21 -0800
Reply-To: Lactation Information and Discussion
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From: Joan Edelstein <[log in to unmask]>
Subject: [Fwd: Stop Support of Anti-Choice Organization]
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Thought you'd appreciate the email a friend of mine sent to Amazon.com
after sending her the information posted on Lactnet.
Joan
> I was appalled to learn that Amazon.com has an association with the
> American Life League, a conservative organization that opposes not
> only a woman's right to choose, but also birth control, Hepatitis B
> and rubella vaccination, and other programs that support individual
> choice.
>
> An annoucement on the American Life League's website at
> http://www.all.org/store/index.htm states that with every purchase
> from Amazon.com, "a portion helps American Life League continue its
> pro-life mission."
>
> After searching the Amazon.com website, however, I was unable to find
> any information disclosing this association!
>
> Is the League providing misleading information? Why is their
> association with Amazon.com so prominently identified?
>
> If you are unable to provide a satisfactory explanation I will not
> only stop making purchases from Amazon.com but will also alert
> everyone on my e-mail list to this situation.
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Date: Sun, 12 Mar 2000 11:00:43 +0100
Reply-To: Lactation Information and Discussion
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: Grandmothers
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> Hi,
>
> Thinking about offering a class (either pre-or post-natal) for grandmothers of
> breastfeeding babies. If any of you have given this type of class, I would
> love
> to hear the kinds of information you've included in your session.
>
> Thanks so much for any input.
> Tammy Arbeter - [log in to unmask]
Hi Tammy,
I did not give such a class, but I'm preparing to write a book(let) for
grandmothers: how it changes their lives, their relation with their adult
children that become parents themselves and differences in childrearing
and-feeding views. And the importance of breastfeeding and -support ofcourse.
But it will be in Dutch initially, so I doubt if it's of much use for you :-)
Wish you success, the idea is great!
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
http://www.users.skynet.be/eurolac
[log in to unmask]
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Date: Sun, 12 Mar 2000 11:07:23 +0100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: "Gift" packs
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> These packages certainly
> aren't given out with any altruistic motivation.
> Unfortunately, the hospital "saves" around $18,000 per year in not
> having to purchase
> volu-feeds, nipples, etc. which they get "free" because they give
> out the sample packs! This
> is a tough obstacle to get past.
If governements really mean what they say when stating that more children must
breastfeed longer in their country, they should be aware of this and make
arrangments to assure hospitals of sufficient fundings to purchase whatever they
need. IF they need it and WHEN they need it.
Gonneke van Veldhuizen, IBCLC
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Date: Sun, 12 Mar 2000 11:33:27 +0000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: heather <[log in to unmask]>
Subject: Re: breastmilk
In-Reply-To: <002501bf8b8e$48829ec0$525008c3@sachs-davis>
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Magda says:
>It is going to be hard to stay on the ground of the human relationship, when
>the opposition has defined the debate not as one of competing health gains
>but as a matter of restricting the transfer of a poisoned body fluid.
You are right, I know....and it is very depressing. it's not only HIV, but
the issues that arise every so often when yet another study reveals how
'polluted' breastmilk is with PCVs and whatever else they look for.
It's on this basis that 'organic' 'baby milk' is marketed.
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
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Date: Sun, 12 Mar 2000 06:53:57 -0500
Reply-To: Lactation Information and Discussion
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From: Patrica Young <[log in to unmask]>
Subject: Re: Shields versus cups and finger feeds-long
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Dear Darlene, I really agree with what you say about use of shields, early
pumping etc. Remember the old saying about "walking in someone else's
mocassins". Many hospital LCs do not have the luxury of time and must do
what works at that moment in that situation. I think your observation that
some babies only need 2-3 times with the shield and then "figure it out" is
very important. And you obvivously aren't just handing out shields willy
nilly with no cautions. I think pumping and finger feeding the very
newborn is very off-putting to the mom and only separates them,
discourages mom and leads to no BFing within a day or 2 at home.
We aren't right or wrong in using shields in the hospital with proper
guidance. We are doing what works with that baby and mom at that time.
Several days down the road the LC outside of the hospital is seeing a
different baby and a different mom than the ones a few days before in the
hospital! Maturation takes place in the baby and in the mom :-) Mom is
not as fragile as the first day or two, can cope more, can follow
information and tips better.
Also using cup feeding or finger feeding - I see it as a way to get
calories into the baby and/or as a way to correct a problem. Some suck
"deficient babies" need the milk however you can get it in (cup), then they
figure out how to suck. Others are sucking ineffectively and need some
"lessons" (Finger feeding).
These are just not either /or situations, so much depends on the
circumstances and reasons for the problem in the first place. I think we
are lucky to know and use so many more things than we used to. Breast
compression (yes, thank you Jack!) and super thin silicone shields and
SNS's and positioning info and just so many things that we didn't have or
know 30 years ago. Sincerely, Pat in SNJ
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Date: Sun, 12 Mar 2000 07:42:07 -0500
Reply-To: Lactation Information and Discussion
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From: Patrica Young <[log in to unmask]>
Subject: Fw: HIV and breastfeeding
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Received from Ted Greiner
> Date: March 11, 2000 12:46 PM
>
> To everyone one the WABA mailing list (send us a "remove" reply if you
want
> off):
>
> This is the third time I am writing to you about the issue of HIV and
> breastfeeding. This may seem exaggerated, but it is one of the major
> tragedies of our time. Of course this is particularly the case for the
> individuals suffering from it, especially in poorer countries where drugs
> are out of reach economically, where infant feeding choices for
> HIV-positive women are extremely difficult (and lacking still in a good
> research base), and where all too often both mother and child are
innocent
> victims of cultures which accept male promiscuity and where women have
> little or no power over their own sexuality. My friend Pamela Morrison,
> helplessly
> watching the devastation occurring in her homeland Zimbabwe, refers to
this
> with understandable indignation as "father-child transmission."
>
> There are also broader dimensions to this tragedy. Many of the people
> struggling to combat this terrible AIDS problem seem (incorrectly) to
have
> assumed that the new UNAIDS/WHO/UNICEF policy calls for pressuring
> HIV-positive women to accept artificial feeding or that only in extreme
> cases of poverty would it be "acceptable" for an HIV-positive woman to
> breastfeed. They seem to perceive breastfeeding promotion as an obstacle
to
> implementing the new policy. Increasingly I am coming across calls in the
> AIDS literature for an end to breastfeeding promotion. Frustration over
how
> difficult it is to implement the new policy may also lead to a tendency
to
> exaggerate the magnitude problem. For example, the UNAIDS submission to
the
> ongoing
> Commission on the Status of Women states incorrectly that in 1999 the
"vast
> majority" of children with HIV got it from breastfeeding.
>
> Just at this critical time when many women may be feeling they perhaps
> should not breastfeed in case they have HIV, and government support to
> avoid an overall decline in breastfeeding is most necessary, many
> governments are becoming doubtful about whether they should promote
> breastfeeding. The HIV crisis itself is stretching health budgets to the
> limit. Even within the United Nations agencies, resources that used to go
> toward assisting countries in breastfeeding promotion are now monopolized
> by the HIV crisis. In fact, this decline in UN involvement in
breastfeeding
> outside the HIV issue was the basis for a statement of concern by the
> bilateral donor agencies at the 1999 UN ACC Subcommittee on Nutrition
meeting.
>
> The recently published randomized trial from Kenya (R. Nduati et al,
Effect
> of Breastfeeding and Formula Feeding on Transmission of HIV-1, A
Randomized
> Clinical Trial. JAMA. 2000;283:1167-1174) found that 30% of HIV-positive
> women who were randomized (after informed concent) to formula feed their
> infants, who were provided with free formula and support, did not
"comply"
> completely with formula feeding. That is, they breast-fed in addition.
> Women do not want to artificially feed in public in many countries
because
> of the risk of stigmatization. One small study recently found that 15 of
19
> Indian women who were told they were HIV-positive informed their husbands
> and 11 of them were cast out of the house and family, separated from
their
> children. This kind of tragedy will continue until governments
successfully
> convince
> their people that this issue must be openly discussed and that HIV is not
> something affecting only bad people who somehow deserve it, but also can
> infect good and honorable people. Ironically, this implies that even
> providing HIV-positive women with free infant formula, information and
> support (let alone just recommending they artificially feed) is likely to
> place their infants in the feeding pattern of greatest overall risk:
mixed
> feeding. (Even more so for those who are simply advised to artificially
feed.)
>
> Like other recent papers that have used incomplete or incorrect
definitions
> of breastfeeding and found that breastfeeding transmits HIV in about 16%
of
> cases, Nduati et al got much more media attention around the world than
the
> Coutsoudis et al paper (Coutsoudis A, et al, 1999. Influence of
> infant-feeding patterns on early mother-to-child transmission of HIV-1 in
> Durban, South Africa: a prospective cohort study. Lancet 354:471-6) which
> found that exclusive breastfeeding from birth did not seem to transmit
much
> HIV. As most of you know now, the latter was the first prospective study
to
> define exclusive breastfeeding properly and to inform pregnant mothers of
> its benefits so that many actually put it into practice and could be
> followed up.
>
> Rather than leading to any change in the UN policy, the Coutsoudis et al
> paper has itself been widely criticized and written off by many in the
> "establishment." This is not just unfair, it is unscientific. The proper
> way to criticize a paper is to write a letter to the editor and give the
> authors a chance to defend themselves, add additional information, or
admit
> certain weaknesses (which all studies have). As I mentioned in my last
> message, several letters were published in Lancet (Nov 27, 1999) and
> responded to by Dr. Coutsoudis. Now she has provided us with additional
> information, both on her original study and on the preliminary, still
> unpublished results of the follow up which has taken place since then.
>
> Several of you wrote earlier to ask if things you have received from me
> could be pubished in various newsletters. In the present case, you may
> publish what I wrote above, but nothing from Dr. Coutsoudis letter below
> may be published.
>
> With kind regards to all,
>
> Ted Greiner, PhD
> Coordinator, WABA Research Task Force
> http://www.waba.org.br
> http://www.welcome.to/breastfeeding
>
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Date: Sun, 12 Mar 2000 09:19:18 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Jon Ahrendsen <[log in to unmask]>
Subject: Subject: Powdered blood? (not really related to BF)
Comments: cc: [log in to unmask]
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Powdered Blood? Actually in my hometown of Manning Iowa USA we used to have
a factory called locally "the blood plant." What they did at this plant was
to get the collected blood from cattle at the meat slaughterhouses and
process the blood. My father gave me a tour of the plant once when I was a
small boy. Basically they took the liquid blood and dried it into a powder.
The dried powder was then bagged and shipped off to other locations to be
used in fertilizer and in the manufacture of adhesives or glue.
The smell from the plant was pungent and noticeable. Our farm was nearly
three miles from the plant and if the wind was from the North we could smell
the plant at our farm.
Jon Ahrendsen, MD FAAFP
Clarion, Iowa
now Ceduna, South Australia till October 2000
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Date: Sun, 12 Mar 2000 10:00:39 -0500
Reply-To: Lactation Information and Discussion
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From: Clayton and Anne Nans <[log in to unmask]>
Subject: inappropriate email
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>Subject: [Fwd: Stop Support of Anti-Choice Organization]
>
>Thought you'd appreciate the email a friend of mine sent to Amazon.com
>after sending her the information posted on Lactnet.
>Joan
>
>> I was appalled to learn that Amazon.com has an association with the
>> American Life League, a conservative organization that opposes not
>> only a woman's right to choose, but also birth control, Hepatitis B
>> and rubella vaccination, and other programs that support individual
>> choice.
>>
Joan, I feel this an inappropriate email to send to this lactation group.
The pro-life/pro-choice debate does not belong here.
Thanks for your consideration,
Anne Nans, RN, IBCLC
Woodbridge, VA
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Date: Sun, 12 Mar 2000 10:12:04 -0500
Reply-To: Lactation Information and Discussion
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From: newman <[log in to unmask]>
Subject: governments
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But Gonneke, you know that governments don't mean that seriously. We want
mothers and babies to breastfeed longer, that's for public consumption, lip
service. They are beholden to the formula companies just as paediatric
societies are. Anyhow, multinationals rule, not governments.
Jack Newman, MD, FRCPC
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Date: Sun, 12 Mar 2000 10:17:47 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Laugh for the Day
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Hi all,
My uncle just sent me this story! Doesn't say whether the baby was definitely
breastfed or not, but given the description, my guess is yes!
Smiles,
Carol Schlef, RNC, MSW, IBCLC
in (today) sunny St. Louis, where it can't decide if it's winter or summer!
As ham sandwiches go, it was perfection. A thick slab of ham, a fresh bun,
crisp lettuce and plenty of expensive, light brown, gourmet mustard.
The corners of my jaw aching in anticipation, I carried it to the picnic
table in our backyard, picked it up with both hands but was stopped by my
wife suddenly at my side.
"Hold Johnny (our six-week-old son) while I get my sandwich," she said.
I had him balanced between my left elbow and shoulder and was reaching again
for the ham sandwich when I noticed a streak of mustard on my fingers.
I love mustard.
I had no napkin.
I licked it off.
It was not mustard.
No man ever put a baby down faster. It was the first and only time I have
sprinted with my tongue protruding. With a washcloth in each hand I did the
sort of routine shoeshine boys do, only I did it on my tongue.
Later (after she stopped crying from laughing so hard) my wife said, "Now you
know why they call that mustard 'Poupon.'"
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Date: Sun, 12 Mar 2000 09:52:37 -0600
Reply-To: Lactation Information and Discussion
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From: Barbara Wilson-Clay <[log in to unmask]>
Organization: Austin Lactation Associates
Subject: hydrocephalus
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Having worked extensively with a baby with hydrocephalus, I feel strongly
about the benefits of long-term breastfeeding. Hypotonia (low muscle tone)
extends to the tonality of the muscles of the mouth. The infant's inability
to handle solids may be due to both hypotonia and to sensory issues, but
breastfeeding is physical therapy for the mouth. The study the American
Dental Association did (looked at 9 yrs later by Labbok who applied a meta
analysis to the data) described a reduction in maloclussion by about 40-50%
in infants breastfed for a year. This indicates an increase in oral motor
strength, positive affect on jaw alignment, etc. as the result of extended
breastfeeding.
An interesting study that Kay Hoover and I talk about in our book describes
a group of Dutch infants who were studied to examine the effect of
breastfeeding on neurological development. The infants were classified at
birth as normal, slightly abnormal, or frankly abnormal. At age 9 the
children were reexamined, and the mothers described their infant feeding
practices. The researchers discovered a small but significant beneficial
effect of breastfeeding on neurological status that persisted even after
adjustment for confounding issues. It was unclear whether the effect came
from a substance in the milk or from the improved psychosocial aspects. But
no matter, the effect was positive on the children. Therefore,
breastfeeding would seem to be a benign or beneficial way to feed/mother the
child. This refutes the OPINION of the mother's therapists, who are blaming
breastfeeding, rather than the child's abnormality, on the feeding problem.
My own experience with a child with hydrocephalus who was breastfed for
close to 4 yrs. is briefly described in the Breastfeeding Atlas , where the
child is pictured. I will share that anecdotally, his neurologist asked the
boy's mother after the CT scan done at age 4, "What miracle drug have you
been giving him?" The MD said that the boy's brain looked better than most
of the scans he sees. There were far fewer of the spongy cavities than are
normally seen with this condition. The boys mother, who went on to become
an LLL Leader, attributes their close emotional bond to extended nursing,
and feels she would have had a much more difficult time bonding and
remaining close to him through all their difficulties had nursing not
facilitated that. Last time I had direct contact, the boy had some autistic
behaviors and wasn't yet talking. He was learning to sign, however. I was
very grateful to be able to work with this heroic mother over the years she
breastfed.
I would suggest the mother try to find a cooperative way to work with the
therapists, educating them, but also agreeing to work diligently to find
foods the child can eat. Another special child I worked with who has Turner
Syndrome had lots of oral hypotonia and difficulty initiating solids. We
worked with thin, nutrient rich foods like egg yolk, yougurt with small
amounts of olive oil mixed in it, very thin potatoe soups. That child was
also nursed forever (almost 3 now) and HER specialists are astonished by her
good growth.
Finally, before I give the citations for all the studies I'm quoting, I want
to add that Prentis found no evidence that extended nursing indicated
parental obsession, or that extended bfg was harmful to children so long as
other efforts to encourage other types of nutrition were pursued. She did
find that toddler nursing reduced infection, esp. in stressed environments.
M. Labbok, G. Hendershot: Does breastfeeding protect against malocclusion?
An analysis of the 1981 child health supplement to the national health
interview survey, American J Prevent Med, 1987; 3(4):227-232.
C. Lanting, V. Fidler, M. Huisman, et al: Neurological differences between
9-year old children fed breast milk or formula as babies, Lancet
1994;344:1319-22.
A. Prentice: Breastfeeding and the Older Infant, Acta Paediatr Scand/Suppl
1991; 374:78-88.
Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com
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Date: Sun, 12 Mar 2000 10:07:57 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Barbara Wilson-Clay <[log in to unmask]>
Organization: Austin Lactation Associates
Subject: Philly conf
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I will be in Philly speaking at the Private Practice workshop conf. over the
May 19-20 weekend. As I know a lot of LCs attend this particular conf, I'd
like to try to organize a Lactnet table so I can visit in person with some
of the East Coast people I know from Lactnet but live too far away to ever
get to meet in person. I want to try to arrange a way to do this, so I
would love it if those of you who are planning to attend would give me a
holler so I can know how many to try to accomodate.
Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com
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Date: Sun, 12 Mar 2000 17:02:22 +0100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: governments
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> But Gonneke, you know that governments don't mean that seriously. We want
> mothers and babies to breastfeed longer, that's for public consumption, lip
> service. They are beholden to the formula companies just as paediatric
> societies are. Anyhow, multinationals rule, not governments.
>
> Jack Newman, MD, FRCPC
Yes, Jack :::sigh::: you're right.
But you know psych's say that daydreaming people live longer, so I love to
daydream, that in a better world ...
Gonneke van Veldhuizen, IBCLC
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Date: Sun, 12 Mar 2000 10:38:14 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: "Linda J. Smith" <[log in to unmask]>
Subject: another one bites the dust (rant)
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Hi all,
In the middle of a nasty spring snowstorm yesterday, a grandma called to
rent a pump for her daughter whose baby is 2 weeks old. Seems breastfeeding
was going fine until the mom got a shot of depo-provera for birth control
the day before, then her milk supply plummeted. (She was pumping several
times a day for some reason). The provider had warned the mom that
"sometimes milk supply may be affected" but gave her the shot anyway. The
mom is 17, living with grandma, boyfriend/ father of baby is happy she's
breastfeeding and very supportive.
To quote Dr. Jack, ARGHHHHH! Did anyone think to mention LAM to this
mother? Or at least wait another few weeks? Or even ask if they were having
sex? Sheesh.
THIS is why I keep teaching, preaching, and occasionally ranting. As a song
says, "another one bites the dust." Sigh.
p.s. my daffodils survived the snow, but my son's car did not survive its
argument with a rural guard rail. He's bruised but OK, thanks to his seat
belt.
Linda J. Smith, BSE, FACCE, IBCLC
Bright Future Lactation Resource Centre
Dayton, OH USA
http://www.bflrc.com
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Date: Sun, 12 Mar 2000 12:32:56 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: references for mother told to wean
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In a message dated 3/12/00 9:27:18 AM EST, [log in to unmask]
writes:
<< The occupational therapist and the speech clinician who are supposed to
give this child therapy, have told the mom that the child has no
motivation to learn to feed himself or to speak because of his "constant"
nursing. They threatened not to continue treating him, that it is wasted
time, as long as he keeps on asking to nurse during the sessions. They also
told the mom that she must see a psychologist because it is "obvious" that
she (mom) is the one who wants to continue nursing, that she has some
problem. They said that this mom must "sever" herself from her baby in
order for him to move forward developmentally----!!!!! >>
Perhaps this mother should ask her child's therapists for their references,
saying that she needs to see the research on which they base their
recommendations and that she won't act on their advice until she has seen
peer reviewed evidence published in a reputable journal. In the absence of
such evidence their recommendations represent cultural biases, not science,
and this mother has a complaint she can take to their superiors.
I think they have the greater obligation to prove their assertions but if she
wants evidence to support prolonged breastfeeding, I suggest Katherine
Dettwyler on the natural age for weaning. It was published in La Leche
League's NEW BEGINNINGS and is probably available on the LLLI website. I'm
sure a search of LACTNET archives would reveal other good references too.
Alice Martino
in central New York State
"Illegitmati non carborundum" -- which is Latin-of-sorts meaning "Don't let
the bastards grind you down."
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Date: Sun, 12 Mar 2000 12:33:55 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: Anne Williams <[log in to unmask]>
Subject: white tongue
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I visited my acupuncturist this past week. I have always known part of their
evaluation is to look at a person's tongue. She is a M.D. from China and has
practiced acupunture for over 30 years. She said that usually in an adult a
white tongue is an indicator of poor digestion. She said poor digestion or
difficulty with peristalsis was often the case in infants too, but sometimes
it could also be an indicator of respiratory problems in infants. For those
of you who are still curious...
Anne Williams RN BSN IBCLC
San Diego California, soon to be Pensacola, Florida :>)
[log in to unmask]
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Date: Sun, 12 Mar 2000 13:25:59 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Nancy H Jones <[log in to unmask]>
Subject: A question?
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>>Thought you'd appreciate the email a friend of mine sent to Amazon.com
after sending her the information posted on Lactnet.
Joan
> I was appalled to learn that Amazon.com has an association with the
> American Life League, a conservative organization that opposes not
> only a woman's right to choose, but also birth control, Hepatitis B
> and rubella vaccination, and other programs that support individual
> choice.
>
<snip>
I am a new subscriber to Lactnet. It was highly recommended to me by my
colleagues as being a professional list pertaining to lactation.
If the subscribers here have "a problem" with any individual who differs in
their political postion, then I imagine this list is not for me.
I also don't understand what this possibly has to do with lactation. Can
anyone shed any light on this for me?
Nancy Jones, RN
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Date: Sun, 12 Mar 2000 12:56:42 -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: Amazon.com associates
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All that statement on the pro-life website means is that they have an
arrangement to sell books through their web site via amazon.com. I have the
same arrangement on my web site. If you buy books from amazon.com via one
of the websites that are associates, then the web site gets a small
kick-back (just a few percent of the price). For example, on my web site,
Sue Ann Kendall, my web-frau, gets the money. It doesn't amount to much!
I am sure that amazon doesn't pay any attention at all to who becomes an
associate. Anyone can become an associate and sell books from the web site
in collaboration with amazon.
Also a gentle reminder that LactNet is not the place to discuss abortion,
immunization, or circumcision.
Kathy Dettwyler, grumpy in Texas
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Date: Sun, 12 Mar 2000 12:57:13 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Bonnie <[log in to unmask]>
Subject: Mandibular hyperplasia
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Hi! I'm new to the site and hope somebody will be able to help/suggest. =
Last week I worked on the Labour & Delivery unit of our hosp. A baby =
girl was born @ 35 wks and she was missing her Rt. ear and had an =
asymmetrical jaw (rt. side). I was asked to assist with br.fdng. as the =
baby was having difficulties. She was making every effort to latch but =
was unable to maintain it. Her suck was quite weak when assessed. She =
fed fair as long as I compressed mom's nipple & held it for her. She =
spent only a few hrs. in NICU for obs. & was then transferredf to the =
norm. nursery. Two nights later, I was working on the post-partum unit =
and had this M/B couple as part of my assignment. The nurse on the =
evening shift had developed a br.fdng. plan which involved using the SNS =
& having mom pump after the feed. As the baby was preterm her =
requirements were 30cc q3h. There had been a consult. placed to =
genetics. They stated she had a manibular and poss. maxillary =
hyperplasia and Rt. ear dysplasia. No definite dx of a syndrome @ this =
point. It was suggested mom attempt brfdng for only 15-20 mins/feed so =
as not to tire baby out. A 30cc syringe was taped btwn mom's breasts & =
a 15" #5 feeding tube was taped to the nipple. Mom seemed to manage well =
with this. Baby latched & the suckling had definately improved since I =
had seen her after birth. She still tended to slip off the nipple, esp. =
as time @ br. increased. She even seemed to be gasping for air, though =
not occurring consistently. She was able to relatach. The feedings =
did take longer than 20 mins. Mom then pumped approx. 10 mins. but was =
discouraged at the little milk vol. she was obtaining. I suggested to =
the nurse coming on to the day shift they weigh baby AC/PC to see how =
well baby was withdrawing br. milk. I was not there the following night =
& am unaware of how well baby was doing etc. Has anyone encountered this =
before and I wonder if the difficulties were R/T the prematurity, the =
jaw, or a combination of both?
Thanks, Bonnie
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Date: Sun, 12 Mar 2000 11:45:18 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Joan Edelstein <[log in to unmask]>
Subject: Re: Inappropriate email
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My sincere apologies - I thought I had seen the original email about
this site on Lactnet. Obviously I was in error.
Joan
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Date: Sun, 12 Mar 2000 14:40:30 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Johanna Berger <[log in to unmask]>
Subject: hydrocephalus/hypotonia
Comments: To: [log in to unmask]
Too bad this mom can't get another PT and speech therapist. My radar
always goes up when "professionals" become this rigid and critical of a
parent. It is disrespectful and harms the therapeutic relationship. If
they really felt that they needed to get this child eating more solids to
work on the hypotonia (swallowing can be a problem), there are easier
ways to work with mom and have mom become a parnter in the process.
It's possible that mom will always be skeptical of their
advice/recommendations/plan for her son. How sad...to have been so rude
and unprofessional as to put this child's need for therapy at a probable
stand still.
IMNSHO, this speaks to how we need to present ourselves to mothers and
families, not only choosing our words carefully, but how we sound when we
present those words.
Johanna Berger, LSW
Breastfeeding Counselor
Bala Cynwyd, PA
________________________________________________________________
YOU'RE PAYING TOO MUCH FOR THE INTERNET!
Juno now offers FREE Internet Access!
Try it today - there's no risk! For your FREE software, visit:
http://dl.www.juno.com/get/tagj.
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Date: Sun, 12 Mar 2000 14:59:22 -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: appropriate on Lactnet.
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No, this discussion re:amazon.com and who uses it, doesn't have anything to
do with lactation and isn't an appropriate for Lactnet, as I'm sure others
will agree. We do sometimes takes very different stances on lactation
issues tho :-) Please don't give up on us yet. Sincerely, Pat in SNJ
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Date: Sun, 12 Mar 2000 15:26:54 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Carol Brussel <[log in to unmask]>
Subject: hydrocephalus
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<< There were far fewer of the spongy cavities than are
normally seen with this condition. >>
barbara reports this result with a baby with hydrocephalus; i, too, had a
patient whose baby had a very rare genetic disorder, and early on he was
found to have such a condition. a later scan showed it had completely
resolved. the doctors were very impressed. at just over a year, he was found
to be frankly aspirating everything - which had been a problem until he began
solid foods. when in the hospital after discovering this (you can see how
hard it is to be helpful long distance, i was under the impression that a
swallow study had been done long before), a specialist came to see the mother
and baby. after seeing him she turned to the mother and said incredulously
"has he always been this healthy?"
he had never had an illness. and of course, it is probably for the best that
they didn't do a study before, because he was fully breastfed all that time,
and now gets HM only through his g tube, and has only limited nursing times.
carol brussel IBCLC
another true believer in the the importance of human milk
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Date: Sun, 12 Mar 2000 12:43:45 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: shields, herbs, and directly discussing issues
Comments: cc: [log in to unmask]
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Barbara: Because your post mentioned two subjects (nipple shield over use
and herbs) I have discussed recently, I'm assuming (perhaps falsely) that
one of your intended targets, is me. If it is, I'd really appreciate it if
you would email me personally as well as to the list. I whole heartedly
agree that both shields and herbs have appropriate and inappropriate
circumstances in which they are used. Now, let me give you a bit more
context...
I am now seeing (and these are just the ones I'm seeing) 3-5 moms PER WEEK
or 12-20+ per month being given nipple shields (both high contact and old
style) by our local hospital nurses (none of whom are IBCLCs) and home
health (some of whom are IBCLCs). This is in a hospital that has about 100
births per month. COME ON...really, do YOU honestly think that this is an
appropriate level of shield dispensing? Most of these moms have been handed
a (as in ONE) shield within 5-10 min of attempting latch and sent home with
NO FOLLOW-UP care except being told that they should get the baby off the
shield in a week. In 90% of the cases, time at the mother's bedside would
have been enough to overcome latch problems. Most of these moms are told
that they have flat or inverted nipples while there is very little evidence
showing this. Most of the moms were not given any other alternatives such
as using an Evert-It (which I really like), pumps or Hobbit or othe inverted
nipple shells. Most of these moms are terrified they'll lose or destroy the
one shield they have and won't leave home. And, many of them were never
counseled to the hazards of shields on milk supply or improper washing
leading to yeast or bacterial mastitis. Sorry, but I'd say that it reality
out of 100 births, if given enough support, only 2-3 AT MOST should require
this device. I'd be curious as to what you would consider to be an
appropriate number.
Now, on to the next issue...herbs. Yes, herbs are substances which if used
improperly without education and experienced counsel, can be hazardous. Did
you know that 80-90% of health care even in developed nations is delivered
by lay people such as mothers? This is a documented fact and most people
want information so that they can go forward with their self-sufficient
health management. I must say that I see more problems as the result of
so-called experts handing out prescriptions and people not realizing that
"even" (and I really mean especially) FDA-approved prescribed substances
given by licensed practioners need full informed consent and not see them as
a blanket endorsement of safety. In clinical studies on health education
and informed consent, most physicians believe that they give 10 times the
amount of education than they actually do (once they are taped and count the
minutes, they actually concede to this). If you are suggesting that I
personally am not qualified, I can provide a long list of certifications,
graduate and post-grad training, as well as professional, peer-reviewed
publications (as opposed to say my recent article in Mothering--if that is
what is really bothering you). As a practitioner, I do not dole out devices
or herbs on a very regular basis. However, they are options that may be
helpful if used appropriately.
My biggest concern with herbs is the fact that there is such a wide variety
in the quality, potency, and residual pesticide, toxic trace minerals, &
fungicide, of available products. Secondly, there is good cause for concern
over interactions between ALL drugs including herbs. My experience with
other practitioners who suggest or "prescribe" herbs is that they are more
careful with these and provide more education than prescribed medications,
which are either presumed safe or totally avoided during bf. It is true
that we desparately need more randomized, controlled trials (RCTs) with
herbs and of course more RCTs that will address the needs of nursing moms.
I am personally conducting 3 research projects now and I serve as a reviewer
for the Office of Alternative Medicine, the CDC, and other branches of DHHS.
I mention this because some of you may not be aware that work IS actually
being conducted in this area and that most of this work takes into account
the long history of use of many alternative and complementary health
practices. The historic context of herbs and
pregnancy/childbirth/breastfeeding is a fascinating one, which I encourage
you to investigate.
Lastly, I think that some practitioners have way too much ego invested in
the issue of patients taking action on their own behalf. We can educate,
provide support, caution, and provide both clinical studies and lead by
example, but in the end for competant decision makers, the choice is theirs.
Do you want your patients to feel comfortable discussing all their options
with you? Please try to have an open mind...
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, author, organic
gardener, photographer, lapidary creator, lousy cleaner.
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Date: Sun, 12 Mar 2000 15:45:12 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Kathleen Bruce <[log in to unmask]>
Subject: thanks
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Thanks to those who remind us all that Lactnet is not a place to share
political views. Thanks. Kathleen
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
Williston, Vermont
mailto:[log in to unmask]
http://homepages.together.net/~kbruce/kbblact.html
LACTNET Archives http://peach.ease.lsoft.com/archives/lactnet.html
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Date: Sun, 12 Mar 2000 12:53:36 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Chris Hafner-Eaton <[log in to unmask]>
Subject: costs of formula to hospital
Comments: cc: [log in to unmask]
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Anne: Out of curiosity, how large of a maternity unit do you have (i.e.
how many births per month and ALOS)? TIA!
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, author, organic
gardener, photographer, lapidary creator, lousy cleaner.
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Date: Sun, 12 Mar 2000 12:56:50 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Chris Hafner-Eaton <[log in to unmask]>
Subject: agreement
Comments: cc: [log in to unmask]
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Pat: I had forgotten how much we agree on issues. I second both your
shield and HIV posts. We really need to get together at ILCA. Do you have
a roommate yet?
warmly,
Chris H-E
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, author, organic
gardener, photographer, lapidary creator, lousy cleaner.
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Date: Sun, 12 Mar 2000 15:39:53 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: newman <[log in to unmask]>
Subject: letter from a mother (sorry, long)
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I thought I would attach this letter I got today. For interest's sake. I
realize that mothers do not always understand what health professionals tell
them, and I have been quoted myself as saying things I would never have said
in a million years. But still, I think this woman's story tells volumes
about what is wrong with how we help mothers start breastfeeding and how we
deal with problems. I am not blowing my own horn because the mother really
did this on her own and didn't contact me until this letter. But what she
says should be of interest especially for LC's. Are we missing something in
what we expect from LC's in their training? After all, going a few days
without a bowel movement in the first few weeks usually (but not always) a
sign of poor intake. Surely even the least experienced LC should know this.
Also, depending on scales is a losing proposition, both for weight loss and
weight gain. We must depend on observation of breastfeeding, not the scale
and especially not the 7%, 10% or whatever percent is currently in vogue. Of
course, in many hospitals people call themselves LC's who are not, and that
could be part of the problem.
"Why in the world was I never told about this "open, pause, close" type of
sucking!!! How is it that I could see my Pediatrician several times, a
lactation consultant at the hospital, and watch the hospitals "baby channel"
for 2 solid days and I still end up with a baby who wasn't gaining?!
"It was only because I have the internet and found your webpages that
"disaster was averted"! After one of my usual 1 1/2 to 2 hour nursing
sessions I noticed my 3 1/2 week old daughter was still agitated and hungry.
Per my Ped. oc's request I gave her 2 1/2 oz.of formula. Extremely
frustrated I began surfing the net in search of something....anything that
could enlighten me....I guess I felt something was missing. When I found
your page and began reading I started to cry. I had been starving my baby.
Inspite of HOURS and HOURS of time spent "nursing", my baby was only getting
a tiny portion of the perfectly adequate milk supply my breasts contained.
"So close and yet....so far away"!
"MY BABY WAS NOT LATCHED ON PROPERLY AND WAS NOT GETTING ENOUGH MILK! Your
pictures and especially your emphasis on the "open, pause, close" type of
sucking was just what we needed. I woke her up from her "formula induced
coma :o)" and hooked her up just the way your pages suggested and VOILA!
She was drawing in mouthfuls of milk right away! I did have to use breast
compressions as my daughter had been latching on and sucking improperly for
3 1/2 weeks! I anticipate compressing while nursing for a while until she
gains in sucking ability. I also benefited from your suggestion to WAIT
UNTIL THE BABY OPENS HER MOUTH--WIDE!! I had been "chasing the baby with the
breast" and so she had never learned to do this properly--We are still
working on this each time.
"Bottom line is that inspite of my efforts to get help from LC's, nurses,
and my doctor; No one asked to actually observe my latch-on and the baby's
sucking. It didn't matter that I told them that I didn't think the baby was
latching on well. The doctor said that some babies just don't suck well and
to begin supplementing with formula. The LC said I was doing fine because
she had gained a few oz. over a few days and the other "signs" of getting
enough were there. This, inspite of the fact that I told them she would go
24 hours without a BM quite frequently and that I felt she wasn't latched on
well and would slip off easily compared to my other children. The LC said
that some babies will go a day without a BM and because my nipples weren't
sore she was latched on properly (not so!!).
"I am a mother of 5 children and have nursed two children to 23 months. I
thought I was a pro and apparently so did everyone else and yet BF was
failing and my baby was almost starving. It is only because of your
webpages that I now have hope to continue BF and my daughter can begin to be
nourished properly."
Actually not my web page, since I don't have one. But many websites do carry
my stuff.
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Date: Sun, 12 Mar 2000 14:23:04 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: Pam Wiggins <[log in to unmask]>
Subject: Powdered human milk
Mime-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
I think we could have a new industry here. Just sell your milk wholesale,
where enterprising people can process and dry it,package it and sell in the
supermarkets for big profits! NOW AVAILABLE: Powdered Mommy Milk: The
REAL thing
I live near a meat packing plant (Smithfield hams) where they dry pig blood
and send it along to the chicken farms for CHICKEN FEED!! And just so you
won't want chicken for dinner tonight, they also put ground up chicken guts
into chicken feed.
Pam Wiggins, IBCLC
Franklin VA
http://www.lapub.com
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Date: Sun, 12 Mar 2000 22:27:00 +0100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: herbs and other non-allopathic medicine
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> that we desparately need more randomized, controlled trials (RCTs) with
> herbs and of course more RCTs that will address the needs of nursing moms.
> I am personally conducting 3 research projects now and I serve as a reviewer
> for the Office of Alternative Medicine, the CDC, and other branches of DHHS.
> I mention this because some of you may not be aware that work IS actually
> being conducted in this area and that most of this work takes into account
> the long history of use of many alternative and complementary health
> practices.
Chris, could you please let us know when and where these studies are published
as soon as they are ppublished. It indeed is hard to find good research on
non-allopathic therapies and medications. They either are ruled out as
unscientific rubbish or without any second thoughts accepted as a ''no cure-no
harm'' type of medicine. Which of course both are short-sighted points of view.
I also think, in discussing non-allopathic medicine, it is wise to make a
difference between ''herbal remedies'', ''homeopathie'', ''Bach's therapy'',
''fytology'', etc, which all work different and use plants or other things in
different ways.
BTW, I am one of those self-medicating moms, but as a LC I never prescribe (do
not want to and am not legally allowed to) either allopathic nor non-allopathic
medication, not even fenugreek. I do tell moms what possibilities there are and
refer them back (with a listing if they wish) to either their family dr or
medically schooled non-allopathic practioner. (In The Netherlands patients
cannot go to any other dr/specialist withour family dr's referral, so I do not
refer to a pediatric or anything).
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
http://www.users.skynet.be/eurolac
[log in to unmask]
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Date: Sun, 12 Mar 2000 16:35:21 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Kathleen Bruce <[log in to unmask]>
Subject: politics
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Hi. Politics does *not* belong on Lactnet. I am sorry that this was brought
up. This discussion is not supposed to be on Lactnet.
Kathleen
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
Williston, Vermont
mailto:[log in to unmask]
http://homepages.together.net/~kbruce/kbblact.html
LACTNET Archives http://peach.ease.lsoft.com/archives/lactnet.html
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Date: Sun, 12 Mar 2000 14:19:44 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: letters from moms
Comments: cc: [log in to unmask]
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Jack: Thanks for sharing that touching letter. I save all of those in two
places...one in a chart (if they've been seen) and the other in a "warm
fuzzy file." There are those days when we all need a bit of encouragement
that we make a difference in lives.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, author, organic
gardener, photographer, lapidary creator, lousy cleaner.
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Date: Sun, 12 Mar 2000 16:48:12 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Kathy Dettwyler <[log in to unmask]>
Subject: Herbs
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I thought Barbara Wilson-Clay brought up some really excellent points in her
post. I am not an LC of any kind, don't help breastfeeding mothers
directly, don't know much about herbs. I did hang out for a while with
Patricia Stuart-Macadam, who is a firm believer in homeopathy (I am not, but
she and I are still friends!).
I am not concerned about people like Chris Hafner-Eaton, or T. Low Dog, or
other people who really know their stuff about herbs *and* are knowlegable
about breastfeeding as well, working with mothers under controlled
circumstances.
What concerns me is:
(1) the general public's lumping together of all alternative medicines
including herbs, nutritional supplements, homeopathic medicines, Bach flower
remedies, etc. into one big group and not really having any idea that there
are differences among these. I've heard people refer to ginko and garlic as
"homeopathic medicines" for just one example. I've heard people say that
you can take any "herbal" medicine, in any quantity -- that you can't
overdose on them. I've heard people refer to Vitamin C as an herbal
medicine. I think the great unwashed masses out there just lump all this
stuff together.
(2) the allopathic medical professionals who don't know a thing about herbs
or homeopathy or nutritional supplements, and who therefore either tell
people they are all useless and to stay away from them, or tell people they
are harmless and to take as much as they want of whatever they want. Just
one example: My radiation oncologist asked if I had any complaints (besides
the usual side effects of radiation) and I mentioned that the hot flashes
from chemotherapy-induced menopause were really annoying. The usual
treatment for hot flashes is estrogen, but I can't take estrogen because my
breast cancer is estrogen-receptor positive. I said "Do you know of any
herbal treatments or nutritional supplements that might help with the hot
flashes but not act like estrogen on the tumor cells?" (I'm thinking here
about soy and yam, etc.). And he looked me straight in the eyes and said
"Sure, take whatever you like. Can't hurt, might help." I just smiled
thinly and kept my mouth shut. I've read enough of the soy literature to
know that soy is highly controversial in the context of breast cancer --
some think it helps a lot, others think it hurts, and there are studies to
support both sides.
Kathy Dettwyler
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Date: Sun, 12 Mar 2000 18:11:08 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Susan Hergert <[log in to unmask]>
Subject: Who makes the choice? Let's not be paternalistic
Comments: To: [log in to unmask]
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Chris said:
> Lastly, I think that some practitioners have way too much ego invested
> in
> the issue of patients taking action on their own behalf. We can
> educate,
> provide support, caution, and provide both clinical studies and lead
> by
> example, but in the end for competant decision makers, the choice is
> theirs.
> Do you want your patients to feel comfortable discussing all their
> options
> with you? Please try to have an open mind...
I have to say I agree here. I have argued before that sometimes we run
the risk of becoming paternalistic with the women who seek our help.
Really, in the long run, it is up to THEM. It is our responsibility to
educate and offer our best suggestions, but...not to say "this is how it
will, or won't be." There are other professionals whom we tend to bash
when we hear stories about how "my doc said I have to do this, or the
nurse said I can't do that." Let's not fall into that trap!
Susan
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Date: Sun, 12 Mar 2000 17:42:25 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Barbara Wilson-Clay <[log in to unmask]>
Organization: Austin Lactation Associates
Subject: not priv. pract.
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I realize I called the Philly conf. the Private Practice workshop and it;s
not. It's the conf. in May (19th and 20). sorry about confusion. I still
want to do a lactnet table.
Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com
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Date: Sun, 12 Mar 2000 17:56:36 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Barbara Wilson-Clay <[log in to unmask]>
Organization: Austin Lactation Associates
Subject: herbs and shields
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I have nothing but the greatest respect for anyone who publishes their
findings and attempts serious study of their specialty. Chris Hafner-Eaton
is to be commended for her efforts.
My concern about use of shields, other types of breastfeeding equipment, and
of herbs is always that they be used intentionally, in an informed clinical
sense, and that the person suggesting their use is acting within the scope
of their practice (an ethical issue that concerns us as individuals and as a
profession) and that they do not employ therapies that put their clients at
risk. Herbs may be a choice that parents have a right to employ, but I have
an obligation to comment if I think that this choice places someone at risk.
My comments were to point out that there is a lack of critical thinking and
discussion in many of the comments about use of herbs. I certainly don't
defend ignorant use of shields. The reason for the comparison was to point
out an irony in our thinking. It's a Tarzan thing: Shields Bad, Herbs
good. Science is more complicated than this. Hopefully, as scientists, we
can have intellectual discussions about these issues without suspecting one
another of personal attacts.
Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com
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Date: Sun, 12 Mar 2000 19:15:15 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Kathy and Paul Koch <[log in to unmask]>
Subject: article needed
Comments: To: TLC <[log in to unmask]>
MIME-Version: 1.0
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Does anyone have the February 2000 issue of Scientific American and would be
willing to send me the article (or a copy) titled "The Early Origins of
Autism".
It would be much appreciated! Please contact me privately if you can help
me.
Kathy (mother of a son with an autistic spectrum disorder)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Kathy Koch, BSEd, IBCLC
Great Mills, MD
mailto:[log in to unmask]
http://www.bftopics.org
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Date: Sun, 12 Mar 2000 16:41:44 PST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Traci Mills <[log in to unmask]>
Subject: Shallow latch
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How do you identify shallow latch? Is this when the baby latches onto the
nipple only? I've seen photos and read the discussions here, but am not
getting the picture in my head. Explanations are appreciated.
Also, I am trying to get some clinical time in before I take the exam. Any
suggestions about how I can go about this. There are no IBCLC's practising
here, Wichita Falls, TX, as far as I know. The hospital just route my calls
from floor to floor.
TIA,
Traci in Texas
______________________________________________________
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Date: Sun, 12 Mar 2000 20:33:39 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Mary Renard <[log in to unmask]>
Subject: Re: shields, herbs, ... in defense of Barbara W-C
Comments: To: Chris Hafner-Eaton <[log in to unmask]>
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Dear Chris,
I can only surmise that perhaps you have never had the pleasure and honor of
meeting and working with Barbara Wilson-Clay. I do not know a more caring
and gentle teacher and consummate professional. I cannot fathom
characterizing any post of Barbara's as having a 'target' in the way you
have used the term. Barbara takes every opportunity to teach and to point
out the many complicating facets to any situation. She is thought-full
(misspelled purposely) and I find that I generally learn something every
time she speaks up.
Knowing Barbara, I am sure that she was NOT 'targetting' you and I find it
most unfortunate that you would interpret her words in a way that has
somehow put you on the defensive in a rather aggressive way (if that's not
an oxymoron). Barbara is a problem-solver, a coalition-builder, a
consensus-seeker. She is respectful of colleagues and clients. She most
assuredly has an open mind; she is one of the most intellectually curious
people I know. She is well-known for her depth of knowledge and
appreciation for the wondrous art and science of breastfeeding and lactation
support.
Barbara doesn't need me to defend her but I feel I must protest your rather
jarring response to her post, as I enjoy Lactnet for its generally peaceful
atmosphere and I cringe at your strong words. I am sorry that you felt
attacked, and just as you stated that you wished you had been contacted, so
too I wish you had requested a clarification before posting a response that
assumed such an attack.
Respectfully,
Mary Riley Renard, RN, BSN, IBCLC, LLLL
Vienna Virginia USA
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Date: Sun, 12 Mar 2000 20:57:26 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Michelle I. Scott" <[log in to unmask]>
Subject: Adult use of brmilk
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Dear colleagues,
I have a friend who was dx with uterine cancer last spring. Had a =
complete hysterectomy, bowel resection ASAP, then in October she had a =
blockage in the intestine (not sure if it was scar tissue or tumor), and =
she had that removed and the colostomy reversed. All went well until =
about a month ago, when she had incr. levels of tumor marker and began a =
"milder" course of chemotherapy. Now she has lost 10 pounds, all foods =
just "run thru" (ie lots of diarrhea), and she is on a clear liquid diet =
for the past week. Not much improvement. We have a mutual trusted =
friend who is bf her 8 month old and is willing to share some =
breastmilk. My sense is that if it just a case of wiped out gut lining, =
then the breastmilk may stimulate regrowth, if it is a real blockage, =
then it needs treatment ASAP, but the brmilk is no worse than the jello =
and chicken broth she is having now.
My question is, how would you dose this friend? I thought of 1-2 =
oz/day, diluted with water. Try it for 2-3 d, then up the dose =
depending on the situation. I advised her to contact her physician =
regarding this idea, and expect skepticism. I figured the oncologist =
may be more open to this since lots of folks with cancer seem open to =
trying alternative treatments along with traditional (?!) procedures.
I am doing an archives search right now as well. Hoping to hear =
from some...Michelle Scott, MA,RD,IBCLC in NH =20
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Date: Sun, 12 Mar 2000 20:26:34 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Julius Edlavitch <[log in to unmask]>
Subject: Jack and Kay discuss GROWTH in the BREASTFED BABY
Mime-Version: 1.0
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*********************************************************************
Monday Night March 13th Jack and Kay will discuss
GROWTH in the BREASTFED BABY
Lactation Chat at 9 PM Eastern USA time Monday Nights
With Kay Hoover MA ED and Jack Newman MD
*********************************************************************
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Date: Sun, 12 Mar 2000 22:24:34 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: Photos
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I have not had a problem getting film developed, with photos of breasts,
abscesses, nursing mothers in lots of postitons, twins, etc. But I always
use the same photo lab and I made sure to get acquainted with the manager
there, giving him my business card and brochure, and a brochure of a
conference where I was speaking. Once I had some photos published I brought
in the publication to show them, especially the ones that his lab had
developed. They were pleased and have always been extremely nice. I think
proving that you are a responsible professional to them and not some strange
person is the key.
Jane Bradshaw
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Date: Sun, 12 Mar 2000 19:14:26 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Monique Schaefers <[log in to unmask]>
Subject: need a TX IBCLC
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I need to find a IBCLC and/or LLL Leader and/or NMC person in Williamson
County, Texas. Mother to be states she goes to Austin for medical and
Cedar Park for WIC. She needs prenatal BFing help. First baby she was
told she had inverted nipples. She tried BFing and got very frustrated
and afraid she was starving her baby - quickly moved to formula within 1
week. Second child she didn't bother BFing. This child (third) she
really wants to be successful. Any takers???
--
Monique
[log in to unmask]
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Date: Sun, 12 Mar 2000 23:03:36 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Robert Cordes DO <[log in to unmask]>
Subject: Singulair used intranasally
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Why someone wants to use this intra nasally I don't know.
However I called a pediatric pulmonologist the other day about using this
med fora 5 year old. Presently its approved down to 6 years old. He told me
that in a few weeks it will have approval as young a 2 years old.
That should answer this particular breastfeeding question.
Merck or the FDA should be able to give the doctor more info.
Rob
Rob Cordes, DO
pediatrician
mailto:[log in to unmask]
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Date: Sun, 12 Mar 2000 23:59:31 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Carol Brussel <[log in to unmask]>
Subject: personal investment
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i was off of lactnet for a while, and i will say frankly that one of the
reasons is that so often when an interesting discussion begins, touching on
differences in practice (and things that i feel merit serious consideration),
the discussion is often completely stalled by someone protesting that they
feel personally insulted, abused, etc. (i don't just mean you chris, really).
this has the effect of completely stalling what might be a reasonable
discussion.
this is one of the criticisms used against women in the workplace - "they are
too sensitive." please, let's not let a professional discussion turn into a
venue for taking things personally. i must say that some of the people i
disagree with are probably the people whom i would find the most fascinating.
hey, i argue with jack all the time.
that is a logical fallacy, by the way. argumentum ad misericordiam.
carol brussel IBCLC
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Date: Sun, 12 Mar 2000 21:27:22 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Monique Schaefers <[log in to unmask]>
Subject: BFing after csection
Comments: To: Parent-L <[log in to unmask]>
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Is it common hospital policy/practice to not allow BFing in surgery or
recovery? Thanks in advance for any insight into this issue.
--
Monique
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Date: Sun, 12 Mar 2000 21:51:28 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Chris Hafner-Eaton <[log in to unmask]>
Subject: respect for each other as professionals
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Dear Barbara and Mary: Honestly, I must say that I hope this is the sign of
open, intellectual discourse that we are having. Surely, Barbara, you have
a good friend in Mary and I have not had the pleasure of working with either
of you directly. It was only after I received 4 private emails asking if I
was disturbed by "Barbara's targeted implications" (not my words) about
herbs and shields that I decided to respond both to her personally and to
LN. So, perhaps, I allowed myself to be sucked in. Clearly, there is much
to be discussed within these topics given the responses privately and
publicly. My intent in replying was not to spear or flame anyone, but
defend "a" position (not solely my position). I truly believe that we, as
IBCLCs, need to support each other and enhance each other's knowledge base
by sharing information. Thanks for all the wisdom you do share with us.
Warmly,
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, author, organic
gardener, photographer, lapidary creator, lousy cleaner.
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Date: Mon, 13 Mar 2000 06:47:59 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Patrica Young <[log in to unmask]>
Subject: Re: BFing after csection
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As far as I know BFing in recovery is Ok and done most places. Gives mom &
baby a chance to get acquainted and nurse while mom still is numb - most
comf she will be for next few days. We all know the benefits of nursing as
soon after del as possible for baby. recovery room staffing is frequently
one on one nursing(staff) and so this person is able to observe mother and
baby and help out very well. What's the problem? Sincerely, Pat in SNJ
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Date: Mon, 13 Mar 2000 21:44:37 +1000
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From: Denise Fisher <[log in to unmask]>
Subject: increasing fat content in milk
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Sorry I am behind in my Lactnets - really I only had one day off to be
grumpy before night shift, then one day off to be really snarky afterwards...
Regarding using the 'mother lying on her back' position to breastfeed in
the hope that the fat-rich milk will rise to the top I'm sorry but I don't
think it works that way. The fat, from my understanding, is actually
fairly adherent to the walls of the alveoli and ductules and it isn't until
the breast is emptying well and the myoepithelial cells are squeezing both
ductules and alveoli that the fat is dislodged.
I'm led to believe this position was invented in Australia, but as a fair
dinkum Aussie I'm afraid I really don't like it for anything. I don't
believe it helps babies to feed no matter what their problem and I've seen
some mothers with some corker blocked ducts from feeding like this. Plus,
just how convenient is it - it could well be another reason why a mother
would say no, breastfeeding just doesn't fit into my lifestyle, if she has
to find a bed to lie down every time she wants to feed.
Just my NSHO.
Denise
Brisbane, Australia
****************************************************
Denise Fisher, BN, RM, IBCLC
BreastEd Online Lactation Studies Course
http://www.breasted.com.au
mailto:[log in to unmask]
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Date: Mon, 13 Mar 2000 21:49:57 +1000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Denise Fisher <[log in to unmask]>
Subject: staff education positioning video
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I can highly recommend a video produced by Sue Cox (one of Australia's
grand dames of breastfeeding - she's not on Lactnet so will never know I
called her that :-) ) It's very very good for both staff and mothers.
It's called Mother and Baby - getting it right.
Actually she made it for NMAA. If you contact NMAA (http://www.nmaa.org.au)
you will be able to find out purchase particulars of it.
It really is brilliant.
Denise
Brisbane, Queensland
****************************************************
Denise Fisher, BN, RM, IBCLC
BreastEd Online Lactation Studies Course
http://www.breasted.com.au
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Date: Sun, 12 Mar 2000 20:43:50 -0700
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Patricia L Donley <[log in to unmask]>
Subject: Mandibular hyperplasia
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Bonnie
The characteristics you describe--mandibular hyperplasia, absent ear, and
possible maxillary hyperplasia sound similar to those of either
hemifacial microsomia or Goldenhar's syndrome. (I myself was born with a
milder case of hemifacial microsomia...)
You may find more information about this on a web site called Wide Smiles
(sorry, I no longer have web access, and don't have the web address). I
believe the Wide Smiles web site has pictures of many children with a
wide range of facial anomalies, and I suspect you may find info/links
that could answer some of your questions.
Trish Donley RN ND IBCLC
Fort Defiance, AZ
(on the Navajo reservation)
[log in to unmask]
p.s. My mother says I breastfed just fine!
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Date: Mon, 13 Mar 2000 07:54:52 -0500
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From: "Linda J. Smith" <[log in to unmask]>
Subject: personal vs professional
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Although I have not read all of the posts and thread leading to Carol
Brussell's last post, I have this to say:
Professional disagreement and lively discussion is generally healthy for all
concerned, because it forces us to look beyond personal beliefs to the
evidence behind those beliefs. Personal attacks are inappropriate, period.
Some of us may take a professional challenge personally, because we have
invested much time, energy, thought, and research into a particular
viewpoint or practice.
When our pet theories of the world are challenged (as mine are frequently
when I lecture or teach), we need to take a deep breath, examine the
challenge carefully, tease out whether it was a personal attack (usually
not), and prepare a studied, professional response. In my own life, this
practice has resulted in finding more evidence to bolster my beliefs
(frequently), re-think my beliefs (sometimes), or expand my knowledge
(often.) Occasionally I've even said "I was wrong on XXXX issue."
I can take a professional challenge to my professional opinion. I don't even
mind being criticized for taking an unpopular, new, or "politically
incorrect" position on a clinical issue. However, I'm insulted and
indignant when someone blows me off cause I'm short, fifty-something,
female, from Ohio, or some other non-professional characteristic that is
irrelevant to the professional issue.
(And besides, I'm not even "from" Ohio - I just live here now.)
Linda J. Smith, BSE, FACCE, IBCLC
Bright Future Lactation Resource Centre
Dayton, OH USA
http://www.bflrc.com
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Date: Mon, 13 Mar 2000 07:59:35 -0600
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From: Kathy Dettwyler <[log in to unmask]>
Subject: Scientific American
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Here is the summary from the web site. They don't have the whole article:
The Early Origins of Autism
Patricia M. Rodier
The causes of this baffling and debilitating behavioral disorder
may lie in early embryonic development, when malfunctioning
genes could produce subtle changes in the structure of the brain
stem. New genetic and anatomical studies support this theory
and point toward some likely genetic culprits.
Kathy Dettwyler
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Date: Mon, 13 Mar 2000 10:12:09 -0500
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From: Cynthia Turner-Maffei <[log in to unmask]>
Subject: Re: nipple shields and herbs -- long
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Barbara eloquently writes : "I would urge restraint in our enthusiasm to
uncritically embrace ideas, and temper this with an examination of the
first rule of practice: Do No Harm. This applies to the use of herbs and
viatmins as well as of any type of equipment."
Amen!
Cindy Turner-Maffei, MA, IBCLC
Massachusetts, USA
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Date: Mon, 13 Mar 2000 09:47:25 -0600
Reply-To: Lactation Information and Discussion
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From: "Denny Rice, RN IBCLC, Dallas TX" <[log in to unmask]>
Organization: @Home Network Member
Subject: NEWS
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In the news:
http://www.pslgroup.com:80/dg/16144a.htm
--
Denny Rice, RN, IBCLC
Dallas Texas USA
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Date: Mon, 13 Mar 2000 10:29:25 -0500
Reply-To: Lactation Information and Discussion
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From: Kathleen Bruce <[log in to unmask]>
Subject: Journal Club #2
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So, to the many people who let us know that they are interested in
participating in a Journal Club, please feel free to critically read this
article and the companion article by Amir, and discuss.
? Where is everyone? Don't wait for someone else to do it....let's begin
...read it, and make a comment , please?
: ) Kathleen
"The Treatment of Staphyloccocus Aureus Infected Sore Nipples: A
Randomized Comparative Study." by Verity Livingtone, MBBS, FCFP, IBCLC
and L. Judy Stringer, MBBS, MRCGP, IBCLC, Journal of Human Lactation,
15(3), 1999.
The authors suspected a link between delayed healing of cracked nipples
and Staph aureus infection. Women presenting with cracked nipples, but
without mastitis, had their nipple lesions cultured. Those positive
for Staph aureus were randomized to one of four treatment groups:
- individualized bf technique assistance from an LC.
- topical mupiricin ointment (Bactroban) and bf technique assistance.
- topical fusidic acid ointment and bf technique assistance.
- beta lactamase resistant systemic antibiotics (dicloxacillin or
erythromycin 500mg/qid/10d) and bf technique assistance.
Women were re-evaluated in 7 days, and nipples assessed as
better/resolved, no change, and worse based on pain and skin
appearance. Any cellulitis, mastitis, or fever was considered a
treatment failure, and oral antibiotics were prescribed.
Results: a large proportion of each of the non-systemic treatments
failed to improve, and a significant proportion progressed to mastitis.
79% of women in the oral antibiotic group improved and only 5%
worsened. Fusidic acid outperformed mupiricin, but only a minority of
women were improved in one week with both topical treatments. Optimal
technique alone showed improvement in only 9% of women in this study,
35% of them worsened over one week, and 30% progressed to mastitis. In
all, 25% of mothers treated non-systemically progressed to mastitis, but
only 5% of those given oral antibiotics developed mastitis. The authors
recommend that sore, cracked nipples be clinically diagnosed as impetigo
vulgaris, and be treated with systemic antibiotics for a minimum of 10
days until the skin is fully healed, while improving breastfeeding
technique to prevent added trauma or friction to the nippples.
Other interesting points:
- 5 women in this study reported deep, radiating, burning breast pain
and episodic vasospasm of the nipples, unrelated to immediate sucking.
The authors attribute this to both repetitive gumming of the nipple and
the S. aureus infection.
- The advice to not use soap on the nipples contradicts hygeinic
adjuncts to impetigo treatment.
- 17% of the moms with S. aureus infections had poorly graspable
nipples.
- 10% of their infants had tongue tie, and 12% had significant
retrognathia.
--
Catherine Watson Genna, IBCLC New York City mailto:[log in to unmask]
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
Williston, Vermont
mailto:[log in to unmask]
http://homepages.together.net/~kbruce/kbblact.html
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Date: Mon, 13 Mar 2000 10:39:54 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Denny Rice, RN IBCLC, Dallas TX" <[log in to unmask]>
Organization: @Home Network Member
Subject: "smart" formula
Comments: To: Kathleen Bruce <[log in to unmask]>
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http://www.cup.cam.ac.uk/journals/dmc/birch.pdf
--
Denny Rice, RN, IBCLC
Dallas Texas USA
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Date: Mon, 13 Mar 2000 10:43:07 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Denny Rice, RN IBCLC, Dallas TX" <[log in to unmask]>
Organization: @Home Network Member
Subject: "smart formula" NIH
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Sorry if this has already been posted and discussed, I'm currently
no-mail, leaving for Houston in the am.
http://www.nih.gov/news/pr/mar2000/nichd-06.htm
--
Denny Rice, RN, IBCLC
Dallas Texas USA
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Date: Mon, 13 Mar 2000 12:31:39 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Cindy Curtis, RN, IBCLC" <[log in to unmask]>
Subject: CDC and pumps
I searched the CDC web site for breast pumps and came up with 3252 articles!
Someone told me that the CDC issued a statement about moms not sharing non
rental pumps, is any one aware of this and know where I can locate it?
Thanks!
Cindy
Cindy Curtis,RN,IBCLC
mailto:[log in to unmask]
http://www.erols.com/cindyrn
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Date: Mon, 13 Mar 2000 12:32:03 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Kathleen Bruce <[log in to unmask]>
Subject: Thanks...
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Thanks to all who so nicely have written in that constructive discussion is
not intended to create hard feelings, etc, and I have appreciated all the
good comments about this today...and yesterday.
Let's assume the best about others before we respond with anger, or a fast
trigger...and let's not assume insult unless verified.
And, to those who privately email to another wondering if they are miffed,
or p/od about someone else's note on Lactnet, urging them on to battle, how
about focusing energy elsewhere? : ) If someone has thoughts or feelings
about another's note, why not approach them honestly and directly instead of
the alternative. Thanks. Kathleen.
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
Williston, Vermont
mailto:[log in to unmask]
http://homepages.together.net/~kbruce/kbblact.html
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Date: Mon, 13 Mar 2000 12:36:28 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Kathleen Bruce <[log in to unmask]>
Subject: "A Randomized Controlled Trial of Early Dietary SUpply of Long
Chain Polyunstaurated Fatty Acids and Mental Dev. in Term
Infants."
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The article that Denny mentioned, at
http://www.cup.cam.ac.uk/journals/dmc/birch.pdf, is entitled " A Randomized
Controlled Trial of Early Dietary SUpply of Long Chain Polyunstaurated Fatty
Acids and Mental Dev. in Term Infants." It is a study that is supported, as
it admits, by the NIH grant and by funding from Mead Johnson.
Kathleen
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
Williston, Vermont
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Date: Mon, 13 Mar 2000 13:18:01 EST
Reply-To: Lactation Information and Discussion
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Subject: Re: RE; BFing after c-section
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Monica, I can only speak for what we do in our hospital. Our policy is to
initiate breastfeeding in the recovery room after c-section in all cases
unless the baby's condition / mother's condition precluded breastfeeding.
Otherwise, we do encourage breastfeeding post c-section the way we do with
vaginal births.
Jane Ciaramella RNC, IBCLC
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Date: Mon, 13 Mar 2000 13:35:00 EST
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<[log in to unmask]>
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Subject: Moderation
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Cindy quoted Barbara,
<< Barbara eloquently writes : "I would urge restraint in our enthusiasm to
uncritically embrace ideas, and temper this with an examination of the
first rule of practice: Do No Harm. This applies to the use of herbs and
viatmins as well as of any type of equipment." >>
However, I would add to this that while we need to examine recommendations
and encourage publication of good research on new ideas, I do believe that if
a certain practice DOES NO HARM, and, in fact, may do a body good (use of
cabbage comes to mind here), then by all means, use it even if there is no
evidence based research (yet) on which to base the practice.
I have yet to find a study that says that cabbage is harmful, and I have
plenty of mothers that find it helpful. And yes, if I had the time, the
energy, and the money, I would do a study to replicate the work cited in the
original article written in 1987 by Wendy Rosier in which she advocated a 2
hours on, 2 hours off regimen, NOT attempt to make up another study of my
own. I will admit that I have not been particularly impressed by the other
"research" that has been published on the subject....nor on the conclusions
drawn (necessarily).
When it comes to herbs, vitamins, and other pieces of equipment, we do need
to be cautious and careful, and examine all available written works on the
subject at hand. For example, can nipple shields be a problem? Absolutely!
In which cases? When they are not used carefully, properly, with appropriate
followup, and so on. Can they be helpful? Absolutely! When they are used
carefully, properly, with appropriate followup, and so on.
Jan B -- in cold Wheaton
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Date: Mon, 13 Mar 2000 13:21:43 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: gima <[log in to unmask]>
Subject: What is "milk"?
In-Reply-To: <[log in to unmask]>
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At 02:23 PM 3/12/00 -0500, you wrote:
>I think we could have a new industry here. Just sell your milk wholesale,
>where enterprising people can process and dry it,package it and sell in the
>supermarkets for big profits! NOW AVAILABLE: Powdered Mommy Milk: The
>REAL thing
Unless the dairy industry gets their way.
There is an article in Sunday's paper that tells of the milk producer's
appeal to the FDA to prohibit the makers of soy milk from calling it
"milk." They are trying to "protect the distinct identity of their product,
which, they point out comes from 'the lacteal secretion' of cows." The milk
producers want the FDA to take "appropriate enforcement action" against the
makers of soy milk.
They suggested that the soy people call their product "soy beverage" or
Soya drink" to reflect that it is from a "non-bovine" species. It is
inappropriate to label a product, that is not from the bovine species, with
the word "milk."
The soy industry officials say that "milk" is a generic term attached to a
lot of products, such as coconut milk and Milk of Magnesia. [No mention of
human milk.] And they point out that the term "soy milk" was used in
ancient China as early as the years 25 to 220. The dairy industry claim
that they have rights to the word, and that to call a product "soy milk"
will confuse consumers into thinking that they are getting "milk." Maybe it
will all come down to the dairy industry's being required to label their
product "cow milk."
One suggestion from the Soyfoods Assn. is to call it "soymilk"--one word.
Hey, that sounds familiar.
Of course the uproar has been created by the fact that soy milk consumption
is on the rise, and is being found in general grocery stores now.
They didn't give an address for the FDA. Maybe they need some
enlightenment on the "original" word "milk.".
Pat Gima, IBCLC
Milwaukee, Wisconsin
Mailto:[log in to unmask]
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Date: Mon, 13 Mar 2000 14:54:35 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Kathy and Paul Koch <[log in to unmask]>
Subject: Re: Scientific American
In-Reply-To: <[log in to unmask]>
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>
> Here is the summary from the web site. They don't have the whole article:
>
Yes, I was frustrated by that. I went there before I posed my request.
They seem to have all the other lead articles on-line but that one. I have
since been offered copies of the article, for which I am very grateful!
Kathy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Kathy Koch, BSEd, IBCLC
Great Mills, MD
mailto:[log in to unmask]
http://www.bftopics.org
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Date: Mon, 13 Mar 2000 13:47:51 -0800
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<[log in to unmask]>
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From: Kate Hallberg <[log in to unmask]>
Subject: let down problems
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I'm nomail, but need some assistance. I'm working
long distance with a mom who quit nursing at 2 mos,
started again at 3 mos. She is pumping every 2-3
hours, taking fenugreek,blessed thistle, brewers
yeast, evening primrose,and reglan. Her son nurses
but she believes he doesn't have good latch on. the
main problem for her seems to be her letdown. She
never felt letdown during the first two mos. She and
her LC in Orlando were able to get some oxytocin spray
from Sam (who was posted here some time ago) but she
is finding she needs to use the spray every time she
pumps or she just gets drips. Before she got the
spray she was able to pump 1-2 oz. Now she's almost
out, and she is hesitant to spend $75 for what turns
out to be a four day supply for her.
Baby sleeps well at night so she attributes that and
her lack of letdown to initial breastfeeding problems.
My understanding of oxytocin spray was that most moms
use it a few times and train themselves to letdown.
It's not doing it for her. She's on the pumpingmoms
listserv, but I sent her a few more personal
experiences of pumping from some moms. Any other
thoughts? Please?
mailto:[log in to unmask]
=====
Kate Hallberg, mom to Ursula (5!) and Sage (2.5) http://www.cs.colorado.edu/~kolina/advantages-of-formula.html
http://www.freecloud.com/wackypacks/detail.asp?s=16&p=Similecch.jpg
http://www.bowman.org/ two reasons I left the Bay Area
__________________________________________________
Do You Yahoo!?
Talk to your friends online with Yahoo! Messenger.
http://im.yahoo.com
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Date: Mon, 13 Mar 2000 17:06:47 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Sarah Barnett <[log in to unmask]>
Subject: Trying to reach Nofia Altman
Comments: cc: Reena Barnett <[log in to unmask]>
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Sorry to have to do this but I have tried two addresses and they aren't
working. Nofia could you please email me.
Sarah
Sarah Friend Barnett LLLL, IBCLC
Bronx (New York City), NY - [log in to unmask]
" You are not obliged to finish the task,
neither are you free to neglect it." R. Tarfon
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Date: Mon, 13 Mar 2000 16:39:15 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
Comments: Authenticated sender is <[log in to unmask]>
From: "[log in to unmask]" <[log in to unmask]>
Subject: Re: Powdered Human Milk
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Why wouldn't the public buy into the idea of powdered human milk? If
cow's milk can be powdered and put in a box why not human? What I do
find fairly humourous though is that many people would probably go,
Ewwwww, at the thought of human milk, but they have no problem
drinking something from a cow!
Michelle
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Date: Mon, 13 Mar 2000 18:56:31 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Kathleen Bruce <[log in to unmask]>
Subject: breastfeeding's worth
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Laurie, your 11-7 charge nurse, as Jack has said, is just plain *hateful*
about breastfeeding, and doens't "believe in it, " probably because she has
deep-seated beliefs that relate to her own breastfeeding, mothering, or
feeding choices. It hits close to home, and me wonders why she protests so much.
I hope she is prepared to defend her position, because sometime in the
future, there will be some mother or family who has breastfeeding failure,
turns to formula, has a resulting diabetic child, for example, and ***sues
both her and the hospital involved.** for negligence.
I think that it is up to us as health care providers to REMOVE the biases
that we have about this issue that stem from our own lives, choices, and
parenting, and start promoting breastfeeding as the first line of action in
affordable health care.
I'd like to call for insurance rate reductions for those who breastfeed,
don't smoke, don't drink to excess, wear seatbelts, etc. Why not reward
those who do things that will promote health and not destroy it? Let those
who make other choices pay for them.
Grumpy in Vermont. Kathleen
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
Williston, Vermont
mailto:[log in to unmask]
http://homepages.together.net/~kbruce/kbblact.html
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Date: Mon, 13 Mar 2000 19:05:20 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Kathleen Bruce <[log in to unmask]>
Subject: Second to Kathy D's post
Mime-Version: 1.0
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This is to second Kathy Dettwyler's excellent post on herbs and
breastfeeding, and I thank Barbara for her excellent note...and can confirm
that she is the consummate professional I have ever had the pleasure of
working with.
What Kathy D says is a double-edged sword. Herbs are tools, as are any
medication...and we should not recommend these things without having full
knowledge. I wish I had more knowledge, personally.
Kind regards,
Kathleen
What concerns me is:
(1) the general public's lumping together of all alternative medicines
including herbs, nutritional supplements, homeopathic medicines, Bach flower
remedies, etc. into one big group and not really having any idea that there
are differences among these. I've heard people refer to ginko and garlic as
"homeopathic medicines" for just one example. I've heard people say that
you can take any "herbal" medicine, in any quantity -- that you can't
overdose on them. I've heard people refer to Vitamin C as an herbal
medicine. I think the great unwashed masses out there just lump all this
stuff together.
(2) the allopathic medical professionals who don't know a thing about herbs
or homeopathy or nutritional supplements, and who therefore either tell
people they are all useless and to stay away from them, or tell people they
are harmless and to take as much as they want of whatever they want. Just
one example: My radiation oncologist asked if I had any complaints (besides
the usual side effects of radiation) and I mentioned that the hot flashes
from chemotherapy-induced menopause were really annoying. The usual
treatment for hot flashes is estrogen, but I can't take estrogen because my
breast cancer is estrogen-receptor positive. I said "Do you know of any
herbal treatments or nutritional supplements that might help with the hot
flashes but not act like estrogen on the tumor cells?" (I'm thinking here
about soy and yam, etc.). And he looked me straight in the eyes and said
"Sure, take whatever you like. Can't hurt, might help." I just smiled
thinly and kept my mouth shut. I've read enough of the soy literature to
know that soy is highly controversial in the context of breast cancer --
some think it helps a lot, others think it hurts, and there are studies to
support both sides.
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
Williston, Vermont
mailto:[log in to unmask]
http://homepages.together.net/~kbruce/kbblact.html
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Date: Mon, 13 Mar 2000 19:03:48 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Laura Walker <[log in to unmask]>
Subject: Fw: Pacifiers for pain relief
MIME-Version: 1.0
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----- One of the charge nurses on the unit is part of the hospitals' =
pain management team. One of the suggested methods is to use a pacifier =
dipped in sucrose. Anyone working on pain management for infants ? We =
haven't had pacifiers in our institution for 5 yrs. and really don't =
want to promte their use for any reason because they will be misused by =
staff. They complain now about it on and off and despite all the info =
given to them, it doesn't seem to matter. Overall, their use is =
discouraged until BF is well established. If parents wish otherwise, =
then they have to bring in their own and it is documented. We are a =
level one hospital now but by next year, we'll have a level two =
designation. I searched the archives first but nothing was found. I'd =
appreciate any info anyone has. I haven't seen any of the info yet =
myself. I'm feeling a bit discouraged lately - the 11-7 charge nurse =
said in no uncertain terms that she doesn't believe a word of BF's worth =
to baby and we shouldn't be badgering mothers. The Ross rep has been =
coming around lately too with videos and the day charge nurse has been =
coordinating these. We hadn't been doing that either for the last three =
yrs. More and more, I'm feeling out of the loop. It wasn't a good week =
last week. =20
Laura Walker,RNC, IBCLC
[log in to unmask]
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Date: Mon, 13 Mar 2000 19:27:52 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Kathleen Bruce <[log in to unmask]>
Subject: powdered human milk
Mime-Version: 1.0
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Many would equate powdered human milk with some sort of unpleasant bodily
fluids, no doubt an extension of their own hang ups about breastfeeding,
etc. Kathleen
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
Williston, Vermont
mailto:[log in to unmask]
http://homepages.together.net/~kbruce/kbblact.html
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Date: Mon, 13 Mar 2000 16:58:06 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Venus <[log in to unmask]>
Subject: Vermox & BF
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Hi,
I've been nomail for a while (and still am) but I was wondering if
someone out there can help me on this one:
A mum has been prescribed a single dose of Vermox (100mg) for
pinworms that she and her four year old both have. Her doctor has
recommended not BFing for 24 hours, because the effects are
"unknown", but she doesn't have enough breastmilk stored to feed her
9 month old for that long. She does not want to give formula, and
hasn't yet introduced whole milk to her baby.
I'm stumped on this one. On one hand, I imagine vermifuges are
fairly toxic, but on the other, the dose for a 2 year old is the same
as the adult dose, so how bad can it be? Furthermore, if the whole
family is being treated, might not the baby benefit from a weak dose
filtred through the breast?
Also, is anyone aware of herbal remedies that are safe for BFing? I
would hesitate to recommend wormwood, as it is mildly addictive and
has other side effects, but what about Black Walnut or Grapefruit
seed extracts?
Please respond privately to [log in to unmask]
Thanks in advance
Jennifer Landels, BA, CBE
Vancouver BC
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Date: Mon, 13 Mar 2000 20:08:23 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: "Cindy Curtis, RN, IBCLC" <[log in to unmask]>
Subject: AWHONN and the Code
Comments: cc: LACTIVIST POST <[log in to unmask]>
Our hospital just received the Volume 1 , 2000 issue of Baby Talk magazine
for expectant parents, I believe this is a new publication, on the front
left corner it says "Published with AWHONN" .{Association of Women's Health
Obstetric and Neonatal Nurses}
On page 21 there is a full page ad for ..... Carnation Good Start formulas
and a tear out card to mail in for a "free" magazine published by
Carnation.
Here is the web page for AWHONN : http://www.awhonn.org/ The main AWHONN
page says "Promoting the Health of Women and newborns."
I was shocked to learn that AWHONN would endorse a magazine that breaks the
code and have written them a letter about my disappointment. If you would
like to contact them :
AWHONN
2000 L Street, N.W. Suite 740
Washington, D.C. 20036
(800) 673-8499 (U.S.) ~ (800) 245-0231 (Canada) ~ (202) 728-0575
Cindy
Cindy Curtis,RN,IBCLC
mailto:[log in to unmask]
http://www.erols.com/cindyrn
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Date: Mon, 13 Mar 2000 20:37:02 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: The Breastfeeding Center of Maine <[log in to unmask]>
Subject: Re: videos for staff education
MIME-Version: 1.0
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Janet,
I'm a bit behind on reading posts (HOW DO YOU ALL KEEP UP?),
but my favorite 'detail' video is Chloe Fisher's, "Helping A Mother to
Breastfeed: No Finer Investment". I cue it to 2 sections demonstrating a
nutritive and non-nutritive latch. It breaks the nutritive latch into slow
motion segments. I love the whole video too, about 20 min. long.
Bettina Pearson RN, IBCLC
> I have the VIDA "How to" video. It is great. But I am looking one
> that is very detailed on positioning and latch to reinforce this message
> to staff. Any thoughts on other videos?
> Janet Vandenberg RN, BScN, IBCLC
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Date: Mon, 13 Mar 2000 19:51:48 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Kathy Eng <[log in to unmask]>
Subject: clampdown bite reflex
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I am wondering if any of you experienced LACTNETters have suggestions for
when a baby is really clamping down with his jaw. I am looking for
information beyond the first measures of getting the positioning right,
baby's chin to chest, and putting pressure on baby's jaw/chin with the
mother's finger. The baby that I am working with has the extremely strong
mouth suction and jaw action. When your finger is in his mouth and he is
sucking,
you feel like he is going to take off your whole finger. Mom's nipples are
very cracked and irritated. She is now pumping and giving her milk by
bottle because she is in too much pain to nurse. She has given up on
feeding from the breast.
I'd like to know what are some possible measures to help baby relax it's
jaw when the clamping is extemely severe beyond the measures of latching on
and positioning. Is physical therapy of some kind used? Special bottle
nipples or pacifiers?
Thank you, Kathy Eng, in far southeastern Houston, TX, USA
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Date: Mon, 13 Mar 2000 20:46:32 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Patrica Young <[log in to unmask]>
Subject: Re: Vermox & BF
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Jennifer, Hale says "poorly absorbed orally and high protein binding, it is
unlikely to be transmitted to infant in clinically relevant
concentrations." He goes on to give one case report of a 2 x dose that
dried up mom's milk supply (!) Check the archives, I think we've discussed
this before. Sincerely, Pat in SNJ
P.S. Has mom actually seen worms or had her stool tested or does just the 4
yo have them?
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Date: Mon, 13 Mar 2000 21:17:03 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: The Breastfeeding Center of Maine <[log in to unmask]>
Subject: lactation failure
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Most of us have had this situation, and I'm sure there have been many =
posts, but... I saw a mom in the hospital today, with her second baby, =
via C/S, 3 days post op, getting drops of milk/colostrum by hospital =
pump after nursing. Now I know 3 days is too early, but with her last =
baby her milk never came in, so this is a deja-vou. She breastfed, =
pumped and used the SNS and finally gave up at 1 month. She was =
devastated and had a significant postpartum depression. She had 'general =
hormone' tests that showed nothing. She experienced lots of breast =
changes with both pregnancys, but none afterwards last time, nor so far =
this time, takes no meds, has had no breast surgery or trauma and has =
moderately large symetric breasts that are not widely spaced.=20
Her baby has a wide gape and is eager to nurse, but gets pokey with the =
decreased flow (pre and postfeed wt.6cc in 40 min.). He cup feeds =
formula supplement, and has her genetic disorder "spherocytosis" (her =
first son also had this, and both of them have had the spleen removed).=20
She is reliving her grief, "why does my body do this? why won't it make =
milk for my babies?" Her emotions are raw, and her thinking negative. =
She feels like a failure as a mother if she can grow her babies but not =
nourish them. She doesn't want anything less than nearly full =
breastfeeding. Her definition of success is all or nothing. She will =
not use the SNS or any other device while nursing. She wants to know if =
breast ultrasound would tell her anything. Is there anyway to know why =
this happens to her? =20
Meanwhile she is 'treading water' by nursing 8+ /24 hours, using breast =
compression (which did help a bit), and pumping. Last time she also =
took reglan and some herbs. I've encouraged her to visualize her milk =
flowing and give her body more time. But I also don't want to minimize =
her concerns.=20
TIA for your responses,
Bettina Pearson RN, IBCLC
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Date: Mon, 13 Mar 2000 21:46:26 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: milk and lacteal secretions
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In a message dated 3/13/00 6:14:33 PM Central Standard Time,
[log in to unmask] writes:
<< Ewwwww, at the thought of human milk, but they have no problem
drinking something from a cow! >>
Yep - but if we start calling it "bovine lacteal secretion" they might get
their minds right ;-)
Elaine Ziska
Jackson, MS
(where my dh once said milk glands are "just modified sweat glands".....and
they think we have (body-part) envy, hah!)
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Date: Mon, 13 Mar 2000 22:12:06 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: Drug Info
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Is there a website available to the "public" for breastfeeding and drug
information?
Thanks in advance,
Kathy Suszczewicz
LLL Leader
Virginia
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Date: Mon, 13 Mar 2000 20:15:23 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Chris Hafner-Eaton <[log in to unmask]>
Subject: NON-HUMAN BOVINE MILK >>>
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I'd like to suggest that the dairy industry be required to call their
products "NON-HUMAN BOVINE MILK ____ ( Beverage, or curd, frozen confection,
or whatever product you choose). Don't get me wrong, I happen to love ice
cream (even if it makes me sick--I'm allergic to cow milk protein, not
lactose intolerant), but in all fairness to accurate representation, they
SHOULD bare the burden of full disclosure. Perhaps they need to also label
it as Growth-hormone enhanced, with possible traces of pesticides, unless
it's certified by the Oregon Tilth (or other certifying body) as "Organic".
Humm, this brings up a whole bunch of possibilities of informed consent
'Just my 2 cents. :) I do hope the whole list isn't ticked off at me
now--just the Dairy Council ;)
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, author, organic
gardener, photographer, lapidary creator, lousy cleaner.
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Date: Mon, 13 Mar 2000 23:21:15 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Becky Krumwiede <[log in to unmask]>
Subject: Re: hydrogel
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Maka asked a week ago (I *knew* I could never keep up!):
<< my apologies if someone has already mentioned this; i'm WAY behind! but
it is my understanding based on a study i read about water-based vs.
glycerin-based vaginal lubricants (so sorry, i don't have the reference
anymore--computer crash since then) that the glycerin-based lubricants were
more likely to be associated with yeast overgrowth. i wonder if these
glycerin-based pads will show the same thing? just a thought...>>
I can't say with certainty that we have had NO yeast with the moms using the
Comfort-Aid hydrogel dressings like I can say we've had no mastitis, but I am
certain we've not had an increase in incidence of yeast. In fact, it may be
less than normal. I'll have to intentionally watch for any possible
association.
Becky Krumwiede, RN, IBCLC
Appleton, Wisconsin
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Date: Mon, 13 Mar 2000 23:28:01 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Becky Krumwiede <[log in to unmask]>
Subject: Re: videos for staff education
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Even though I used Chele Marmet's video on positioning for years, there seem
to be so many better ones out now. I absolutely love the video on
positioning done by the Royal College of Midwives, put out by Mark-It TV. I
know it's available on Linda Smith's web site, and I believe also from
Childbirth Graphics in the U.S.
Becky Krumwiede, RN, IBCLC
Appleton, Wisconsin
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Date: Mon, 13 Mar 2000 23:41:51 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Alice Ernest <[log in to unmask]>
Subject: Re: Letdown problems
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Dear Kate,
Just had a mom with letdown problems while taking Zoloft who used
syntocinon nasal spray which worked well for her, but from my research I
learned that if you use it more than once or twice, it can cause a rebound
effect, inhibiting letdown with further use. Wonder if your mom could try
using SNS at breast. It looks like she has all the galactagogues covered!
Best wishes,
Alice Ernest IBCLC
Simpsonville, SC
Where it looks like the peach blossoms have survived a few cold nights.
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Date: Mon, 13 Mar 2000 23:48:30 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Kermaline J Cotterman <[log in to unmask]>
Subject: Cream, revisited + thoughts on "Australian" position
Denise,
You wrote:
<Regarding using the 'mother lying on her back' position to breastfeed in
the hope that the fat-rich milk will rise to the top I'm sorry but I
don't
think it works that way. The fat, from my understanding, is actually
fairly adherent to the walls of the alveoli and ductules and it isn't
until
the breast is emptying well and the myoepithelial cells are squeezing
both
ductules and alveoli that the fat is dislodged.
I'm led to believe this position was invented in Australia, but as a fair
dinkum Aussie I'm afraid I really don't like it for anything. I don't
believe it helps babies to feed no matter what their problem and I've
seen
some mothers with some corker blocked ducts from feeding like this.
Plus,
just how convenient is it - it could well be another reason why a mother
would say no, breastfeeding just doesn't fit into my lifestyle, if she
has
to find a bed to lie down every time she wants to feed.>
I think I was the one who started this subject most recently, in part,
half joking.
I was most kindly "re-educated" by Joy Anderson and Gonneke and have gone
back and done a good bit of reading. I have now formed a better picture
in my mind, and can accept it on the basis of the ductules, immediately
next in line after the alveoli being so small that, while the aqueous
part of the milk can indeed "trickle down", the large fat globules are
"hung up" (as if in a funnel with a tiny
opening) until a really good MER or two comes along to "squirt" them
forward.
I even came across one reference just last night that stated that the MER
actually temporarily "ruptured" the membrane in many of the alveoli,
resulting in the sudden release of fat globules that had previously not
yet even been secreted across the membrane into the lumen of the
alveolus. I had read that somewhere long ago, but I don't remember it's
being mentioned in recent articles. Or did I miss that?
It is indeed a fascinating exercise to imagine the whole process.
And it is quite possible that I have too active an imagination. Or at
least, I devote too much time to using it on things like this!
But I still cannot help but think that part of my reasoning has merit:
1) Depending on the mother's degree of fullness for her storage capacity,
cream that has been released into the ducts may end up getting leaked if
the baby is switched too soon to the other breast.
2) Or if it doesn't leak, but baby doesn't remove much of it before he
releases that breast, my logic tells me that even if a lot of the fat
remains mixed with the skim, at least part of it will, given time, rise
against gravity, like cream used to separate in the glass bottles on the
doorstep in my childhood.
And depending on whether mother were vertical or horizontal for several
hours between, I can visualize this having some bearing on just which
surface of the ducts it adhered to till the next feeding. (This is how I
interpret Peter Hartmann saying that we ought to discard the terms
foremilk and hindmilk, as during some feedings, at certain times of the
day, baby may get more fat as he begins to feed than he got when he fell
asleep at the breast earlier in the day.)
That was the basis for my whimsical "for instance" of a mother with an A
cup or a conical breast, sleeping on her back for several hours, might
end up with any "leftover" cream rising up to collect nearer the nipple,
to go into the baby first even if she sat upright to nurse. I doubt
anybody's going to "experiment" based on my whimsy to disprove or prove
it though.
I don't remember linking any of this with nursing in the Australian
position per se though. I don't know how it got its name either, but I
suspect the platypus figures into it somehow.
What you say may be very true for longer term breastfeeding. But I found
it a spendid position to show moms and their significant others in the
hospital, for use at least in the early postpartum period. With a pillow
tucked firmly under the arm that cradles the head, and the baby draped
over the mom's other breast, or toes pointing to either hip, I found many
moms exceeding grateful to be assisted into this position because:
1) It enabled them to relax and close their eyes, and maybe even catch a
few winks of a nap. They invariably remarked how relaxing it felt, and I
think that helps the MER, and gave them an alternative for when they felt
sleep deprived later at home.
2) it avoided pressure on any CS incision, and took pressure off of
epesiotomy and hemorrhoids.
3) The weight of the baby's head compresses the breast against the chest
wall, so that the baby tended to get a deeper latch and keep it.
4) Gravity distributed much of the breast tissue away from the baby's
face and nose automatically, without any need to hold the breast, and no
chance of "drag" tugging it out of the baby's mouth.
Interstitial fluid would tend to gravitate more toward the lymph nodes
rather than gathering as dependent edema in the pendulous breast.
5) It involves the significant other in learning how to help mom into the
position while she and the baby are learning.
And now, I need to turn my imagination to other things!
Jean
**************************************
K. Jean Cotterman RNC, IBCLC
Dayton Ohio USA
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Date: Mon, 13 Mar 2000 23:04:02 -0600
Reply-To: Lactation Information and Discussion
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From: Bonnie <[log in to unmask]>
Subject: Re: clamp down bite refles....
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I've heard that massaging the jaw prior to and btwn. feeds will help the =
jaw muscles relax as well as applying warm cloths to the jaw. =20
Bonnie
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Date: Mon, 13 Mar 2000 21:25:25 -0800
Reply-To: Lactation Information and Discussion
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From: Linda Rosetti <[log in to unmask]>
Subject: Helping mothers deal with Lactation failure..long
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Bettina,
I think every lactation counselor has dealt with lactation failure...oooh I
hate that word. How can we help these women come to their "mothering" when
they are so disappointed? First one thing we can do, and probobly we're the
only ones who can really understand their grief is to listen and achnowledge
their feelings...as you would with anyone who is grieving. Try to help her
reframe her feelings and rethink her expectations....when a mother sees her
mothering as only breastfeeding or givng birth vaginally or any other number
of "expectations we set for ourselves" We can maybe help her reach her
potential and adapt to that place...she becomes all that our life
expects...the best mother she can be...and it will be the perfect match for
her child...help her see what a wonderful mother she is, how beautiful her
child is, what a wonderful gift she has in this child...whoever and what
ever his road may be. It will take her awhile but with gentle support she
will adjust. I have found that it also helps to achnowledge that her
struggle has helped me to help others...it usually does...someway.
This has been one of the hardest things for me.....to do my REAL job in
helping a woman become the very best mother to her baby...by helping her
breastfeed or if she can't....to help her mother this baby. I'd love to
hear more comments on this very delicate issue.
Keep listening to this mother help her keep trying as far as she wants to
go, help her breastfeed or help her bottlefeed her with the love and
closeness of breastfeeding. Sorry this is long but I've been struggling
with a dear woman who is putting herself through such heartache over
his.;( where's that magic wand when you need it.
Learning from sad situations too
Linda Rosetti
Clarkston, Wa.
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Date: Tue, 14 Mar 2000 00:42:07 -0500
Reply-To: Lactation Information and Discussion
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From: beadie cambardella <[log in to unmask]>
Subject: Re: Grandmothers/reply
Comments: To: [log in to unmask]
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For your bibliography you might add " Transitions to Grand Parenthood" by
Sheila Kitzenger
Good Luck with the class.
Beadie Cambardella RN IBCLC
-----Original Message-----
From: [log in to unmask] <[log in to unmask]>
Date: Saturday, March 11, 2000 7:03 PM
Subject: Re: Grandmothers
>Hi,
>
>Thinking about offering a class (either pre-or post-natal) for grandmothers
of
>breastfeeding babies. If any of you have given this type of class, I would
>love
>to hear the kinds of information you've included in your session.
>
>Thanks so much for any input.
>Tammy Arbeter - [log in to unmask]
>
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Date: Mon, 13 Mar 2000 23:56:15 -0600
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From: Bonnie <[log in to unmask]>
Subject: Biting down....
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Sorry....but after I sent in my last response, I got to thinking...LLL =
Breastfeeding Answer book briefly covers this. They also suggest using =
the finger or thumb to press down firmly on the baby's lower lip =
throughout the feeding. If the finger/thumb slips off, a piece of gauze =
can be wrapped around it. They also suggest a quiet nursing environment =
and dim lighting....
Bonnie
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Date: Mon, 13 Mar 2000 22:08:36 -0800
Reply-To: Lactation Information and Discussion
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From: Lisa Marasco IBCLC <[log in to unmask]>
Subject: Re: clamp down bite reflex
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>>The baby that I am working with has the extremely strong mouth suction and
jaw action. When your finger is in his mouth and he is sucking, you feel
like he is going to take off your whole finger.<<
When I feel what I hear you describing, I get a different picture. If you
are saying that baby's suck feels terribly strong, too strong, and the jaw
is working exaggeratedly, I have seen this in conjunction with babies who
dont' know how to use their tongues to strip the lactiferous sinuses. Unable
to get milk out mechanically, the seem to try to overcompensate with extra
hard suction and/or jaw motions, which hurt mom in the process. This
particular situation I don't interpret as a clamping, but rather a
compensation for a deficit.
If baby is truly clamping, then the causes might be different. Does he have
difficulty keeping the breast in his mouth for some reason, that he needs to
clamp down? Or does he have a "tight" mouth that just needs to clamp down,
or???? There are others on this list with expertise to describe further
causes as well. Since I cannot see or feel what you are experiencing,
however, I could be totally in the wrong ball park.
For whatever it's worth--
Lisa Marasco, BA, IBCLC
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Date: Tue, 14 Mar 2000 14:54:10 +0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Joy Anderson <[log in to unmask]>
Subject: Correction of NMAA URL
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> If you contact NMAA (http://www.nmaa.org.au)
Please note that Denise Fisher wrote the above for contacting NMAA re
the video on attachment. The URL should have been
http://www.nmaa.asn.au
******************************************************************
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: Tue, 14 Mar 2000 09:20:16 +0100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: videos for staff education
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> Bettina Pearson wrote:
> Janet,
> I'm a bit behind on reading posts (HOW DO YOU ALL KEEP UP?),
> but my favorite 'detail' video is Chloe Fisher's, "Helping A Mother to
> Breastfeed: No Finer Investment". I cue it to 2 sections demonstrating a
> nutritive and non-nutritive latch. It breaks the nutritive latch into slow
> motion segments. I love the whole video too, about 20 min. long.
This indeed does have these nice slowmotion parts and I use this video a lot
myself for training hcp's, but not only for these parts, also to point out how
*not* to help a mom to take the baby at the breast. What I find a minor point in
this video is the fact that the midwife is latching the baby instead of the
mother. (BTW the second time the mother does it herself and then the baby' latch
on is better!) I always get the feeling that the helper handling the breasts and
the baby is like teaching someone to ride a bycicle by turning the pedals for
her.
IMO it is very important to have *the mother* latch the baby on and the helper
(LC, nurse, whoever) can -if needed- move her arms, hands, arrange pillows,
footstools, etc. Rule of thumb: mom holds and moves breasts and baby; hcp moves
mom and equipment.
In teaching hcp's to help moms and babies latch on I often use roleplaying and
make sure all have been *the mom* at least once! They have to feel for
themselves what specific kinds of help do or don't do. I mostly use the
'triplets' rollplay": 1=mom, 2=hcp, 3=supervisor/observant. They'll take turns
of 10 minutes each, so it only takes half an hour to have them practice all 3
roles once.
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
http://www.users.skynet.be/eurolac
[log in to unmask]
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Date: Tue, 14 Mar 2000 09:07:39 +0000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: heather <[log in to unmask]>
Subject: Re: Fw: Pacifiers for pain relief
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Laura writes: > the 11-7 charge nurse said in no uncertain terms that she
doesn't believe a word of BF's worth to baby and we shouldn't be badgering
mothers.
There is no substitute for units having a breastfeeding policy - as per
number one of Baby Friendly.
I am sick of the idea that we just deplore 'attitudes' - something that
often comes up as a barrier when dicussing bf promotion here - and
therefore we have to work on changing them before we can expect changes in
bf.
As KB says, someone with this idea may have a ton of emotional baggage and
personal experience, and it is not fair for mothers and babies to have to
put up with the fallout.
I am not usually an authoritarian, but now is the time for units to develop
a bf policy (making sure staff expected to implement it 'own' it and
understand it)...and then if someone doesn't follow it, they have to
retrain, face disciplinary action, or seek another job.
Bf policies are also essential to give support to members of staff who do
support bf - stops them feeling on the fringes.
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
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Date: Tue, 14 Mar 2000 09:17:30 +0000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: heather <[log in to unmask]>
Subject: Re: lactation failure
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Bettina writes:
>Most of us have had this situation, and I'm sure there have been many
>posts, but... I saw a mom in the hospital today, with her second baby, via
>C/S, 3 days post op, getting drops of milk/colostrum by hospital pump
>after nursing. Now I know 3 days is too early
Yes, I agree....too early to be anxious, and lots of time for reassurance.
>Her baby has a wide gape and is eager to nurse
Well, that's good news....
>, but gets pokey with the decreased flow (pre and postfeed wt.6cc in 40 min.
No idea whether this is good or bad in these early days, except we know
babies may take very little in terms of volume in the first days. What
weight gain would you be looking for?
>Meanwhile she is 'treading water' by nursing 8+ /24 hours, using breast
>compression (which did help a bit), and pumping.
I would suggest that skin to skin contact and co-sleeping would be more
important than any of these in these very early days.
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
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Date: Tue, 14 Mar 2000 09:21:42 +0000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: heather <[log in to unmask]>
Subject: Re: Fw: Pacifiers for pain relief
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Correction to my post to make it clear: I said
>I am sick of the idea that we just deplore 'attitudes' - something that
>often comes up as a barrier when dicussing bf promotion here - and
>therefore we have to work on changing them before we can expect changes in
>bf.
I meant 'here' as in the UK - not here on Lactnet.
HWN
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Date: Tue, 14 Mar 2000 09:25:47 +0000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: heather <[log in to unmask]>
Subject: Re: videos for staff education
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>> Bettina Pearson wrote:
>> Janet,
>> I'm a bit behind on reading posts (HOW DO YOU ALL KEEP UP?),
>> but my favorite 'detail' video is Chloe Fisher's, "Helping A Mother to
>> Breastfeed: No Finer Investment". I cue it to 2 sections demonstrating a
>> nutritive and non-nutritive latch. It breaks the nutritive latch into slow
>> motion segments. I love the whole video too, about 20 min. long.
>
Gonneke wrote: >This indeed does have these nice slowmotion parts and I use
this video a lot
>myself for training hcp's, but not only for these parts, also to point out how
>*not* to help a mom to take the baby at the breast. What I find a minor
>point in
>this video is the fact that the midwife is latching the baby instead of the
>mother. (BTW the second time the mother does it herself and then the baby'
>latch
>on is better!) I always get the feeling that the helper handling the
>breasts and
>the baby is like teaching someone to ride a bycicle by turning the pedals for
>her.
Agreed, Gonneke. This video has often been criticised here for this very
sequence, and I use it in training for 'how not to' as well : ) It has a
lot of good points, and technically it is fine, but it is not 'mother
centred' in any way.
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
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Date: Tue, 14 Mar 2000 10:42:58 +0100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: journal club #2
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Hi,
It's taken me some time to lay hands on the article, which explains why it took
me so long to react. So, now I've read the article and the exerpt (thank you
Catherine) and am ready for my thoughts to come out and be written down.
First, I must admit I do not see many infected cracked nipples. I do see lots of
all kinds of soreness and cracks, but they usualy are cured by management
improvement, which now makes me to conclude that they probable weren't infected.
But, I do hear from lots of moms -afterwards- that had stopped brestfeeding
because of persistent sore nipples. Since they did not consult me before
weaning, I can't tell wether these were due to mismanagement and failure to
adjust management (which may -given the overall status of lactation management
knowledge in hcp's around here- may well be the case) or to infection or a
combination of both.
That all to explain that in first instance this article sounded to me as a kind
of ''far from my bed show'', but reading on, I got really interested and started
asking myself some questions.
1. it has always been my understanding that it is kind of hard to get a
lactating breast/nipple/areola infected from the outside, because of the active
anti-infective agents in fresh breastmilk and the activity of the Montgomery
glands. A collegue and me used to joke: ''You'll have to rub your nipples around
at your bottom to get them infected.'' (Well, not to clients in those words,
ofcourse!) Meaning that with normal bathroom-hygiene it should be rather hard
for staphs and streps to come from the gut to the nipple. That made me be
surprised to read that over 50% of women with cracked nipples are positively
diagnosed with S. aureus colonisation.
2. About some other interesting points the autors found (5 women with deep,
radiating, burning breast pain and episodic vasospasm of the nipples, 17% of the
moms with S. aureus infections had poorly graspable nipples, 10% of their
infants had tongue tie, and 12% had significant retrognathia) I wonder how these
relate to normal occurrence of these conditions in mothers and newborns. Is this
more than usual? How much more? If so, that could indicate a increased risk for
developping nipplesoreness and, if not treated well, to nipple cracks and
infection. But that would rather be a secundairy connection between these
conditions and the risk of S. aureus infected cracked nipples.
3. Breast hygiene. Washing the breasts with soapy water will kill bacteria and
thus lower the risk for infection, but it will also increase the vulnarability
(?spelling?) of the skin to injuries and thus increase the risk for infection. I
don't see a solution for this dilemma, other than trying to prevent nipple
trauma by teaching both hcp's and mothers good breastfeeding management
techniques. But that is beyond the purpose of this study.
4. I wondered if the women given antibiotics were screened for or preventively
treated for yeasts? The authors do recognise that antibiotic treatment can
include risks, but did not mention what risks they meant or what they recommend
to rule these out as far as possible.
I was glad to read this study as it gave me new insights in the reason why some
nippleproblems are hard or not te be resolved by improvement of technique. Thank
you Verity Livingstone and Judy Stringer for sharing this information with us
collegues.
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
http://www.users.skynet.be/eurolac
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FN:Gonneke van Veldhuizen-Staas
EMAIL;PREF;INTERNET:[log in to unmask]
REV:20000314T094258Z
END:VCARD
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Date: Tue, 14 Mar 2000 06:09:01 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: Norma Ritter <[log in to unmask]>
Subject: Mothers Nurser request
MIME-Version: 1.0
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I received this email the other day - did anyone else here receive a
request like this? Does anyone know anything about this outfit? Please
reply privately to avoid clogging up the list.
TIA, Norma, who is wondering how on earth a nipple shield could protect
against mastitis!
Norma Ritter, IBCLC
private practice in Big Flats, NY
[log in to unmask]
>First let me introduce myself I am Mrs. LaTina D. McCoy and I am in need
of
your expertise in breastfeeding research. I have applied for a Phase I
Grant at the National Institute of Health and I need consultants to work
on
my project with me. I need to round out my team of expert's.
On July 29, 1997, Mrs. LaTina D. McCoy was issued a United States Patent
on
a nursing shield named Mothers Nurser. The nursing shield is designed to
protect from adverse effects that occur during the breast-feeding
experience. By protecting against such difficulties as severely cracked,
infected, bleeding, blistered, chapped, fissured, bruised, thrush and
mastitis. Other benefits of Mothers Nurser is to aid struggling infants
with difficulty latching on to the breast because of sucking problems or
the
mother's lack of protractility of breast tissue, inverted nipples, and
breast refusal. If a mother is unable to "cope" with these difficulties
without the "aid" of a nursing shield, will most likely "discontinue" her
goal to breast-feed.
The expected result is to extend the length of time a mother would
breastfeed her infants by guarding against these difficulties. Mothers
Nurser is designed to accommodate the various cup sizes of women's
breast.
The natural shape and individual cup size will enhance the actual fit of
the
nursing shield. Thus employing a commercially safe and personalized
product
directly to nursing mothers.
After studying the feasibility of this product Mrs. McCoy feels very
satisfied with its safety, and is extremely excited about the prospects
of
this new product . In order to make the product possible, Mrs. McCoy is
seeking a Clinical Research Consultant to work on her project that would
be
funded by NIH.
Thanks
LaTina
202-606-7221 or home 301-390-4550
________________________________________________________________
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Date: Tue, 14 Mar 2000 06:30:12 -0500
Reply-To: Lactation Information and Discussion
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From: newman <[log in to unmask]>
Subject: vermox
Comments: cc: [log in to unmask]
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Why on earth would the doctor recommend that? As if we didn't know, right?
Vermox is not absorbed from the gut. Therefore, the baby couldn't possibly
get any.
Jack Newman, MD, FRCPC
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Date: Tue, 14 Mar 2000 06:48:04 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Patrica Young <[log in to unmask]>
Subject: Re: negative BF 11-7 charge nurse
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Actually the MCH supervisor needs to ask this particular nurse to go work
in some other part of the hospital. Her attitude and how she expresses it
openly or subtly to mothers is NOT acceptable. What if she didn't believe
insulin was useful to the diabetic? Would she still be allowed to practice
in that area without an attitude adjustment? This is a very serious breech
and your hospital nursing administration needs to handle it. Sincerely,
Pat in SNJ
Please feel free to share this post.
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Date: Tue, 14 Mar 2000 07:38:03 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Michelle I. Scott" <[log in to unmask]>
Subject: Mom with no milk
Comments: To: [log in to unmask]
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I have a theory that this is like the women who can't conceive, then =
adopt and promptly get pregnant, or decide to give up the idea of having =
a child and begin to pursue another passion, and voila, they get =
pregnant.
This mom of yours could not possibly be more uptight about =
producing milk, and the consequences are NO RELEASE. I would keep the =
baby in kangaroo type care, skin to skin, use a sling, order a few =
massages, watch videos of nursing moms, have dad give her a shoulder =
massage before breastfeeding, use soothing music Baroque style music, =
maybe even have a beer or glass of wine, keep the baby in bed at night, =
etc. Meanwhile get the baby weighed every other day, and have her keep =
a "casual" record of output of pees and poops. Keep physician =
advised...
Of course, there may be a another reason why she isn't producing =
milk, but none of the things I suggest can hurt as long as the baby gets =
something to eat, output is monitored, and freq wt checks are done. =
This sounds simplistic--it is, but when we do trainings for peer =
counselors, some of whom are bf, they report greatly increased milk from =
sitting around talking about bf all day! This is one of the reasons =
LLL works for so many mothers. =20
Just my .02 worth. Michelle Scott, MA,RD,IBCLC
=20
=20
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Date: Tue, 14 Mar 2000 06:41:03 -0600
Reply-To: Lactation Information and Discussion
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From: gima <[log in to unmask]>
Subject: Leaking device
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Last year I asked for the name and contact for the device that one applies
to the nipples to stop excessive leaking. Someone sent the name and phone
number. I can't find it, probably because I filed it under the name of the
device.
I have another mother who has heard of such, and wants to try it out. If
anyone has the name, please let me know. I think that we didn't feel
positive about its use, but it is sort of a "this works or I quit" scene.
Thanks,
Pat Gima, IBCLC
Milwaukee, Wisconsin
Mailto:[log in to unmask]
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Date: Tue, 14 Mar 2000 07:47:01 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: Update on mom with sore nipples
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Ages ago I posted about a mom that had excruciating pain when the baby
latched on -- way out of proportion to what it "should" be. It wasn't a
positioning issue; the nipples were not traumatized in any way, and this was
lasting much longer than most initial "latch-on pain." Anyway, I've been
feeling remiss for not posting the end of the story:
Jean Cotterman kindly posted me personally with a possible solution to the
problem which made a LOT of sense, we tried it -- and it worked! Mom is pain
free.... This is Jean's response to the dilemma:
"There are milk-containing dilatations beneath the areola that are, in some
new mothers, overdistended, and very painful if the "belly" of the dilatation
is compressed when overdistended.
"A hot washcloth held over the areola for 3+ minutes will raise the pain
thrshhold. Then gentle digital extraction of 5 - 10 drops will begin to be
less and less painful as the overdistention is resolved. of course, the MER
triggered during all of this will also help to move the milk and undistend
the "sinus.""
When I followed up with mom after suggesting this might work, she told me it
did work -- she was delighted, was now nursing pain free -- and on a further
followup, did not have to do it any more. So I want to say a public thank
you to Jean -- and to also say how much I enjoy and appreciate her thoughtful
posts. She, along with several others on this list, ALWAYS make me think and
look at my practices in a new light.
Jan Barger in Wheaton, eagerly awaiting son Tim's "debut" this week in the
high school musical, "Fiddler on the Roof."
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Date: Tue, 14 Mar 2000 07:49:02 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Nice, Frank (NINDS)" <[log in to unmask]>
Subject: Mebendazole (Vermox)
Comments: To: "[log in to unmask]" <[log in to unmask]>
MIME-Version: 1.0
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I just returned from Haiti where we used Vermox extensively. We treated 233 out
of 691 patients that we saw for worms.
We used in it children under two, but at one-half the dose for children over
two.
We did not use a single dose. Of course, all we could do is empirically treat
for multiple type worm infections. We dose at 100 mg twice a day for three days
for anyone over two years old, and 50 mg twice a day for three days for those
under two.
Now to the breastfeeding question: Maternal plasma levels were very low, and
breast milk levels were undetectable in a case report. The oral dose presented
to the baby would be even lower because of the poor GIT absorption of
mebendazole in the infant.
There is no need to temporarily wean, for one dose, or for the three day course.
Frank J. Nice, DPA, CPHP
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Date: Tue, 14 Mar 2000 22:24:45 +1000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Denise Fisher <[log in to unmask]>
Subject: Re: positioning video for staff
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Heather writes:
Agreed, Gonneke. This video has often been criticised here for this very
sequence, and I use it in training for 'how not to' as well : ) It has a
lot of good points, and technically it is fine, but it is not 'mother
centred' in any way.
Which gives me another opportunity to suggest you try to view the NMAA/Sue
Cox video "Mother and Baby: Getting it Right". You'll not find an LC more
mother-centred than Sue.
(Yeah, OK i am the president of the Sue Cox fan club :-) - no commission
though and all proceeds go to NMAA)
And thank you to Joy for correcting my gaff of yesterday giving you all the
wrong address :-<
http://www.nmaa.asn.au
I know it's available in VHS - please ask NMAA via email if it's available
in whatever format you use.
Denise
****************************************************
Denise Fisher, BN, RM, IBCLC
BreastEd Online Lactation Studies Course
http://www.breasted.com.au
mailto:[log in to unmask]
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Date: Tue, 14 Mar 2000 23:04:00 +1000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Denise Fisher <[log in to unmask]>
Subject: Re: Cream, revisited + thoughts on "Australian" position
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At 00:03 14/3/00 -0500, Jean wrote:
>1) Depending on the mother's degree of fullness for her storage capacity,
>cream that has been released into the ducts may end up getting leaked if
>the baby is switched too soon to the other breast.
I'm just 'musing' here as well Jean. The fat content is released in ever
increasing concentrations as the breastfeed progresses - because the
alveoli and ductules are 'ever increasingly' and more efficiently being
squeezed by the contracting myoepithelial cells as the breast empties. So,
by 'leaked', you mean released into the milk? Yes, I agree it will happen
to a varying degree no matter when the baby is switched.
>
>2) Or if it doesn't leak, but baby doesn't remove much of it before he
>releases that breast, my logic tells me that even if a lot of the fat
>remains mixed with the skim, at least part of it will, given time, rise
>against gravity, like cream used to separate in the glass bottles on the
>doorstep in my childhood.
Two 'musings' here: if it hasn't been released (?leaked) then it is still
adherent to the walls of the alveoli and ductules, therefore it isn't
'mixed with the skim'.
Let's say though that baby was 'half way' through 'emptying' that breast
and wanted no more. So the milk was definitely not 'skim'. What happens to
that fat if baby doesn't return to that breast to feed for say another 5
hours? My understanding is that it re-adheres to the alveoli and ductule
walls again. Now whether that is the top or the bottom is irrelevant -
it's adhered. I don't think it would 'travel' much further than the nearest
surface. Mind you, you are the one who mentioned the very small diameter of
these structures, so maybe it's just the closest wall to the fat globule.
>
>And depending on whether mother were vertical or horizontal for several
>hours between, I can visualize this having some bearing on just which
>surface of the ducts it adhered to till the next feeding.
Hmmmm. Don't know that I buy that.
(This is how I
>interpret Peter Hartmann saying that we ought to discard the terms
>foremilk and hindmilk, as during some feedings, at certain times of the
>day, baby may get more fat as he begins to feed than he got when he fell
>asleep at the breast earlier in the day.)
Now from my readings of Peter's work that's not the way I interpret it. I
believe he is saying that the concentration of fat in the milk throughout a
feed increases 'in a straight line, diagonally upwards' (when it is
graphed). If the baby were to stop somewhere along that straight line then
the line would very soon start to drop directly downwards - because the fat
is re-adhering to the cell walls. Depending on how soon afterwards the
baby goes back to feed on that breast depends on how low the fat
concentration at the start of the feed will be - but it will always be
lower than when the baby FINISHED (emphasis only) on that breast at the
last feed. It may be higher than when baby STARTED on that breast at the
last feed, but it won't be higher than when baby finished on that breast at
the last feed.
I'd appreciate other opinions on this research.
>Australian
>position per se though. I don't know how it got its name either, but I
>suspect the platypus figures into it somehow.
LOL. This I definitely can't disagree with Jean. I'm sure you're right ;-)
>
>What you say may be very true for longer term breastfeeding. But I found
>it a spendid position to show moms and their significant others in the
>hospital,
Now that's funny. My very dear friend Renate also 'argued' with me along
these lines (in a very professional sense of course). And even though I'm
still wingeing about having to do night duty (at my age!!) and you all now
know how cranky I get when I'm on nights, I'll give you the same reply as I
gave Renate:
Why teach a mother something that is only ever useful for such a brief
time. If the problem is going to be an ongoing one, then she needs a
solution for the long term. And these days we just can't waste a single
minute of their very brief hospital stay.
And side lying in bed gives mother the rest and all the other advantages of
lying down without risking the lousy drainage that this position affords
the breast at such a crucial time in establishing her lactation.
Yours in every sense of the word professional
Denise
****************************************************
Denise Fisher, BN, RM, IBCLC
BreastEd Online Lactation Studies Course
http://www.breasted.com.au
mailto:[log in to unmask]
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Date: Tue, 14 Mar 2000 08:04:46 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Laura Walker <[log in to unmask]>
Subject: PAin relief
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I appreciate your reply Heather. The sad part is that we DO have a =
breastfeeding policy! We are revising it now to update it. I'm sorry =
to say that it is not taken seriously. I can put out articles, videos =
and I gave each staff member their own BF self learning packet, but it =
hasn't helped very much. I gave lectures also on the unit but now its =
like pulling teeth to get people to come. Anyway, I still would like to =
hear from anyone who uses or has thoughts about the sucrose pacifiers =
for pain relief in infants. Thanks.
Laura=20
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Date: Tue, 14 Mar 2000 08:10:01 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: media: postpartum depression due to bf
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a snip-it from washington post health section story about baby blues, pg17:
"the lower the DHA.........the more liklihood for depression.
.......breastfeeding significantly lowers the mother's DHA levels. ..."the
baby is literally zapping the mother's supply".
www.washingtonpost.com
choose "health" to read the article or post a question or comment
choose "live online" to chat live tuesdays from 2pm - 3pm est
to respond to the article via email: [log in to unmask]
Debbie
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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Date: Mon, 13 Mar 2000 21:12:35 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: Marie Biancuzzo <[log in to unmask]>
Subject: Re: Normal weaning ages
In-Reply-To: <[log in to unmask]>
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I enjoyed Kathy Dettwyler's enlightening post about "normal" times
for life events. Indeed, we do have "normal" ranges for gestation,
teeth erupting, etc., and I think it would behoove all of us to
follow her lead in thinking this way.
I just had a parent raise an interesting question to me, however. The
dad said that the AAP's guideline to have *exclusive* breastfeeding
for the first 6 months wasn't right; he insisted that as soon as the
infant extends his hand when the food is on the parents' table, the
infant is ready to eat other foods.
I was stumped, and could only repeat the AAP's stance. Kathy, do you
have any thoughts on this? Does this fit with the anthropologist's
view?
>
>The posting to LactNet about normal weaning ages being 2.5 years to 7.0
>years is based on my research. If you have not read it, I highly recommend
>you do so! You can find it as chapter 2 of "Breastfeeding: Biocultural
>Perspectives."
>
>Saying that there is a normal range for weaning in humans is no different
>from saying there is a normal range of length of gestation, a normal range
>for age at eruption of the first permanent molars, or a normal range for
>first menstruation. Weaning is a BIOLOGICAL variable.
--
--
Marie Biancuzzo
Perinatal Clinical Nurse Specialist
[log in to unmask]
Resources to simplify breastfeeding management are available at
http://www.wmc-worldwide.com
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Date: Tue, 14 Mar 2000 08:22:32 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Mary Alice Tinari, MSN, IBCLC" <[log in to unmask]>
Subject: Videos for professionals
Hi friends,
I have been nomail for ages, but have kept up with the archives
sporadically. I am looking for a video to teach professionals about
breastfeeding, specifically nurses. I received a solicitation from AWHONN
for a 2 video set and wondered if anyone has previewed it. I am not talking
about the "How to, Can do" videos. They are great for parents. I cannot
remember the name of the professional one, and the pamphlet is at work, duh.
Please email me privately as well as to the list. Thanks in advance for
your assistance.
P.S. My hours as an LC were increased recently. Your many suggestions about
3 yrs ago when they were cut in half inspired me!
Mary Alice Tinari, MSN, IBCLC
hospital LC in the Philadelphia burbs
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Date: Tue, 14 Mar 2000 06:42:06 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Linda J. Smith" <[log in to unmask]>
Subject: Pacifiers for pain relief
Comments: To: Laura Walker <[log in to unmask]>
MIME-Version: 1.0
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Pacifiers for pain relief? There's a far better way. Check out the January
2000 issue of Pediatrics http://www.pediatrics.org/cgi/reprint/105/1/e14.pdf
for a fabulous article "Skin-to-skin contact is analgesic in healthy
newborns" by Larry Gray, Lisa Watt, and Elliott Blass. Should give you some
mighty good ammunition for keeping pacifiers OUT of your facility.
Linda J. Smith, BSE, FACCE, IBCLC
Bright Future Lactation Resource Centre
Dayton, OH USA
http://www.bflrc.com
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Date: Tue, 14 Mar 2000 08:47:42 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Sharon Knorr <[log in to unmask]>
Subject: Re: Journal Club #2
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Doing the math, correctly, I hope.....(extrapolating to 100 to start, using=
their percentages)
For the original screening, if they cultured 100 women with cracked=
nipples, 54 would be positive for S. aureus and thus included in the=
study, leaving 46 who were negative for staph.
Of these 54, 25% or 14 women who did not use systemic antibiotics would=
develop mastitis versus 5% or 3 women who were using systemic treatment.
Thus, of a total of 100 women initially presenting with cracked nipples, 14=
of them would avoid developing mastitis if they were being treated with=
systemic antibiotics.
If all these women were treated with antibiotics upon the initial=
presentation with cracked nipples, 86% would be receiving systemic=
treatment which they did not need.
Overuse of antibiotics is one of the reasons why so many people today are=
colonized with penicillin resistant staph aureus.
That said, it is obvious that systemic treatment is very appropriate, in=
fact, crucial in some cases where nipple trauma has allowed entry of a=
pathogen such as S. aureaus into the breast. How do we isolate these=
cases and prevent the over-treatment of mothers who may have already been=
dosed prophylactically during birth or early post-partum, thus increasing=
the risk of fungal infection? Are all the women who present with cracked=
nipples at the Vancouver Breastfeeding Centre now being given systemic=
treatment? Should we all be doing a lot more culturing to determine how=
widespread pathogenic infection has become? Are any of you in high-use=
clinics keeping any statistics on mastitis? I am not seeing enough=
clients at present to draw any conclusions. My most recent client with=
very damaged nipples resolved rather quickly with positioning help and=
APNO.
I do think that some of these moms are being infected in the hospital.=
Many hospital personel are becoming colonized with various strains of=
resistant organisms. Infection control through frequent hand washing is=
extremely important. Studies have shown that all parts of a hospital room=
may be contaminated, including furniture and draperies - fix the drapes=
for a mom and then handle her breasts?? Mom should be encouraged to wash=
hands as well. Keeping babies out of nurseries and away from hospital=
personel as much as possible is one way to cut down on the chances of=
babies becoming colonized with these bugs.
It was also interesting in this study to see the connection between deep=
breast pain and mastitis. I think that in our eagerness to avoid=
antibiotics, some moms are being treated ad infinitum for yeast infections=
which may, in fact, be bacterial and amenable to systemic antibiotics.
Looking forward to more discussion on this article.
Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
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Date: Tue, 14 Mar 2000 08:06:55 -0400
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Diane Wiessinger <[log in to unmask]>
Subject: sucrose pacifiers for pain relief?
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>One of the charge nurses on the unit is part of the hospitals'
>pain management team. One of the suggested methods is to use a pacifier
>dipped in sucrose. Anyone working on pain management for infants ? We
>haven't had pacifiers in our institution for 5 yrs. and really don't
>want to promte their use for any reason because they will be misused by
>staff.
Neil Campbell, an Australian MD who spoke at ILCA in the early 90s on
"breastmilk feeding of seriously ill babies" told a story about a baby with
an unusually painful leg infection. The parents were given two options for
pain relief: They could have him sedated to the point where he'd need a
respirator, or Mom could hold him and nurse him virtually 24 hours a day and
they'd be able to get by with lighter sedation. Mom opted for the second
course of action, and he did very, very well, *so long as he was held, with
breast continuously available*.
When this sucrose pacifier thing was first published, it seemed to me a
mighty weak substitute for what has always fed a baby's soul.
Diane Wiessinger, MS, IBCLC Ithaca, NY, who's cured many a tumble - some of
them tooth-chipping and bloody - with holding and nursing
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Date: Tue, 14 Mar 2000 08:23:39 -0400
Reply-To: Lactation Information and Discussion
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From: Diane Wiessinger <[log in to unmask]>
Subject: vermox
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Ah, Vermox! I had a skirmish with it in 1993 (before Tom Hale, who cites
its poor oral absorption and high protein binding). I tried to get further
information directly from the company and ended up getting a note from
someone at Janssen Research Foundation in Belgium, the body of which was
(quoting):
**
1. The number of women whose milk was tested for mebendazole following a 100
mg oral dose is one.
2. Milk peak concentration of mebendazole was 5.0 ng/ml. Time after which
mebendazole was no longer detectable in the milk was 13.25 hours in the
patient studied. High levels of mebendazole in the breast milk are very
unlikely since absorption of mebendazole is limited.
3. The lower limit of detection is less than or equal to 1.0 ng/ml.
4. There is no evidence that mebendazole inhibits the lactation.
5. The patient evaluation was done in Sweden, March 1990.
6. Mebendazole is used in European dairy cattle.
**
I found the dairy cattle comment especially interesting!
Diane Wiessinger, MS, IBCLC, LLLL Ithaca, NY
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Date: Tue, 14 Mar 2000 08:40:40 -0400
Reply-To: Lactation Information and Discussion
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From: Diane Wiessinger <[log in to unmask]>
Subject: lactation failure
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> She doesn't want anything less than nearly full =
>breastfeeding. Her definition of success is all or nothing.
You might gently remind her that her *son's* definition is very different.
He wants her breast fully as much as he wants her milk, and by offering it
with an SNS, he'll be able to get all the milk she's able to produce, for as
long as they both want to.
The only difference between her and other nursing mothers will be that
she'll have more washing to do. But that would be true if she bottle-fed,
and they'd both miss out on breastfeeding.
Sometimes I think adoptive mothers are better off than biological mothers
whose milk supplies are less than perfect. The adoptive mom gets her
priorities straight from the start: "This is my child, whose soul and body
are fed at my breast. Some of it is my milk, but we don't know or care
exactly how much. The rest is love."
I had a very-low-milk mother of a non-latching 17 day old here yesterday,
and she had her first experience with a feeding tube. We had a terrible
time getting it to work - she'd never had him latch before, and somehow the
tubing just wasn't placed right. I finally decided it was because it was
the 13th of the month. But we got it going at last, baby snuggled in, and
they became a nursing couple. She'd been pretty maxed out from all our
efforts, though, and when he needed another nibble before they left, she
offered a bottle. Oh, the face he made! He'd been to heaven and he wasn't
too keen on coming back. Has anyone else noticed that a lot of the babies
who are forced to rely on bottles at the start, end up refusing them
completely once they're able to stay fed at breast?
Diane Wiessinger, MS, IBCLC Ithaca, NY
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Date: Tue, 14 Mar 2000 08:01:54 -0600
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From: Marguerite Herschel <[log in to unmask]>
Subject: Subject: Fw: Pacifiers for pain relief
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I'll repeat the reference to sucrose as one measure for pain relief:
Herschel, Khoshnood, et al. Neonatal Circumcision: Randomized trial of a
sucrose pacifier for pain control. Arch Pediatr Adolesc Med. 1998;152:279-284
We employed a bottle nipple, not a "pacifier" that one would buy in a
store. It was used only during circumcision, though I believe some have
used this method of analgesia for premies getting heel pricks.
Peggy Herschel, MD
University of Chicago
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Date: Tue, 14 Mar 2000 14:22:09 +0000
Reply-To: Lactation Information and Discussion
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From: heather <[log in to unmask]>
Subject: Re: PAin relief
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Laura writes: >I appreciate your reply Heather. The sad part is that we DO
have a >breastfeeding policy! We are revising it now to update it. I'm
sorry to say that it is not >taken seriously.
It's the same all over the world. I have just come from a meeting with
midwives when I asked about their bf policy....they used almost the same
words 'no one takes it seriously enough'. This was in the context of
babies being routinely 'topped up' by a small number of midwives.
It becomes then a staff management issue, as another post suggested.
The boss - whoever it is - has at some point to tell people what to do, and
to introduce sanctions when policy is not followed. People don't like
being told what to do? Tough!
Not that that helps anyone like you, who is just a colleague, of course.
As for pain relief - there's enough known about skin-to-skin and cuddling
and comforting through bf to make pacifiers as pain relief redundant.
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
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Date: Tue, 14 Mar 2000 09:33:49 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: mom with sore nipples
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Thanks for posting this follow up. Yes, Jean is a great resource. She and
Barbara, in particular, have been extremely valuable to me in helping to
remember that, aside from the many and obviously hugely significant
head-trip/confidence aspects of successful bf, mechanics really do matter and
are susceptible to having plain old good logic applied to them.
So often we get trapped in a false dichotomy between "it's all in your head"
on the one hand, and "biology is destiny" --meaning, to too many, that your
body is un-fixable -- on the other. Posts like these really help me to
remember how interconnected these are, and how susceptible BOTH are of help
based on good knowledge and good thinking.
Elisheva Urbas, who started out learning more from the loving-support side
but now is learning every day from the scientists
in NYC
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Date: Tue, 14 Mar 2000 09:24:32 -0500
Reply-To: Lactation Information and Discussion
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From: Kathleen Bruce <[log in to unmask]>
Subject: sucrose pacifiers as pain relief
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Am I missing something?
If someone were going to perform surgery on my body, or my older children's
bodies, I would not consider a lollipop to be adequate pain relief. Why are
we assuming that infants do not require specific pain relief for a surgical
procedure? is it because they cannot vocalize their feelings?
Missing something in Vermont, and still grumpy.
Kathleen
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
Williston, Vermont
mailto:[log in to unmask]
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LACTNET Archives http://peach.ease.lsoft.com/archives/lactnet.html
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Date: Tue, 14 Mar 2000 08:28:56 -0600
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From: Barbara Wilson-Clay <[log in to unmask]>
Organization: Austin Lactation Associates
Subject: milk fat concentrations
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Thanks, Jean Cotterman and Denise Fischer for a stimulating discussion on
milk fat concentrations.
Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com
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Date: Tue, 14 Mar 2000 08:57:15 -0600
Reply-To: Lactation Information and Discussion
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From: Barbara Wilson-Clay <[log in to unmask]>
Organization: Austin Lactation Associates
Subject: jaw clamp
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I agree with Lisa Marasco's view that jaw clamp is frequently the result of
a compensation the baby has adopted due to weakness in some other aspect of
the mechanisms used during breastfeeding. What could that be:
Weakness of the lips can result in inability to form an adequate seal
(creating problems with generating sufficient negative pressure to hold
breast in mouth and to facilitate milk transfer). You could test this by
gently pushing on lips. There should be some "resist" to your push. The
lips should shape easily into a flange, and the seal should be tight.
Weakness of the tongue (caused by tongue-tie, trauma to nerves controlling
tongue due to birth injury -- e.g. forceps, short tongue, or bunched or
elevated tongue). The tongue plays a role with the lips in creating a seal
to hold breast in mouth. Tongue must also express free range of motion to
lift, extend, groove and lateralize in order to facilitate pressure
extraction of milk and to channel milk to back of mouth for safe swallow.
If tongue or lips are weak, baby will often clench with jaws to hold breast
in mouth, to apply possitive pressure on breast to strip milk from ducts,
and to compensate for reduced ability to form negative pressure by applying
excess positive pressure.
Weaknesses in the neck muscles, or injury there may also be causing baby to
posture the head in hyper-extension. This will also tighten the jaw and
create clenching or clamping. Tip your own head back and see the kind of
pull this exerts on your jaw.
Solutions include: Feed baby in postures that emphasize hip flexion with
firm control at the base of the head (on neck and shoulders) to maintain
head position in very slight extension with chin slightly tipped forward.
The lips can be massaged with firm (rather than tickle touch) motions rather
like applying lipstick. Tongue mobility should be evaluated. I find that
doing "push-ups" with a soft gel-filled pacifier or someone's clean finger
provides non-nutritive sucking opportunities to exercise the weak or injured
tongue.
Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com
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Date: Tue, 14 Mar 2000 10:14:00 -0500
Reply-To: Lactation Information and Discussion
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From: "D. McCallister" <[log in to unmask]>
Organization: Marketing =?iso-8859-1?Q?=95?= Graphic Design
=?iso-8859-1?Q?=95?= Writing
Subject: Urgent, need BF friendly CA doctor
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I need to locate a breastfeeding friendly, and supporting doctor in or near
Manteca, California.
I have a friend who is suffering from extreme PPD, and desparately needs medical
attention. She finally got up the nerve to see her doctor yesterday, who told her
that he won't prescribe antidepressants until she weans. Her baby is 7 months and
at this point she's considering early weaning just to get some help. Of course, as
I type this, I am STEAMING!
Can anyone help with off-list replies? Please!
Debbie McCallister
Louisville, Kentucky
Non-professional lurker & breastfeeding busybody
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Date: Tue, 14 Mar 2000 10:08:47 -0500
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From: Becky Flora <[log in to unmask]>
Subject: leaking device
Pat,
The device you are referring to is called BLIS - Breast Leakage Inhibitor
System. You can go to Blis' site and read more about it:
http://www.blis.com
I have read the studies on it (one was published in JHL a while back) and
they seem pretty promising and safe to me, especially when it's this or
weaning!
Becky Flora, BSed, IBCLC
Kingsport, TN
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Date: Tue, 14 Mar 2000 10:39:43 -0500
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From: Cynthia Turner-Maffei <[log in to unmask]>
Subject: Re: Cabbage and engorgement
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I guess I'm the devil's advocate on the cabbage front. I hope no one is
personally offended by my thoughts about cabbage -- I really have nothing
against this cruciferous vegetable, which will certainly be a popular
grocery item this week, at least in the US, for St. Patrick's Day corn beef
& cabbage dinners.
Kathleen quotes Lawrence: "Cabbage is noted to contain sinigrin (allyl
isothiocyanate) and rapine. Herbalists consider rapine to be an antifungal
antibiotic."
I was unable to find any health-associated claims for sinigrin - just
flavor claims: "Sinigrin, a sulfur compound present in cabbage, is broken
down by myrosinase to produce a mustard oil called allyl isothiocyanate, a
sharp, pungent flavor." Hmmm.. could this sharp, pungent flavor dissuade
babies from latching on to a cabbage treated breast?
The potential effect of rapine as an antifungal antibiotic is intersting,
but doesn't indicate any anti-engorgement effect.
Supposing that these chemicals, or some other of the hundreds in cabbage,
might have an anti-engorgement effect, more questions come up in my mind:
1) Do we know if these chemicals can be absorbed transdermally?
2) If they are absorbed transdermally, are there any side-effects of their
presence in breast milk that should concern us?
Regarding Jan's statement that there is no evidence that cabbage is
harmful, I recall Assunta Osterholt, IBCLC's post last year stating that
she had discovered that cabbage can carry listeria. Remembering that
cabbages grow in potentially contaminated soil, we could potentially
introduce microbes and other chemicals via cabbage directly on the breast.
Jan writes further: "If I had the time...I would do a study to replicate
the work cited in the original article written in 1987 by Wendy Rosier . . "
Wendy Rosier's work is a collection of case reports. Case reports
constitute the lowest form of evidence, as categorized in the generally
accepted "Hierarchy of Evidence" (level 7: Case reports); and in the coding
system used in the ILCA Evidence-Based Guidelines book (Code III - Opinions
of respected authorities, based on clinical experience, descriptive studies
and case reports, or reports of expert committees). Case reports are very
important, as they open the field to interest in research. However, they
are not randomized or controlled in any way. One would not replicate a
case study, but design a randomized controlled protocol to test the
suspected effect.
Certainly, more research regarding cabbage will help to elucidate any
potential benefit or harm of its use.
Regards to all,
Cindy
Cindy Turner-Maffei, MA, IBCLC
Massachusetts, USA
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Date: Tue, 14 Mar 2000 10:46:43 EST
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From: Carol Brussel <[log in to unmask]>
Subject: cream rising to the top
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so i am having a fun time visualizing the cream being on the top half of the
breast, then, the mother stooping over to pick something up, and having the
cream head back towards the chest wall, and then, when she does her yoga
headstand, the cream switching to being at the bottom of the breast.
oh come on, now, i thought the milk was constantly being reabsorbed and
remade, which is why the relationship between alcohol in the blood (which is
constantly falling as it is metabolized) and alcohol in the milk stays the
same and you don't have to pump and dump (how i hate that phrase, makes milk
sound like toxic sludge). if this is the case but the fatty cells remain in
the ducts, the next thing we know, someone will be claiming that the fat is
"old and rancid" and bad.
carol brussel IBCLC
and thanks to those who faithfully publish study citations. i have a goal of
one study per day (to at last read the summary), a growing deck of used copy
cards from the medical library, and way too many of them waiting to file, not
to mention a relationship with the librarians (hey, when's that color copier
coming?). i figure, when i win the lottery, all the money will go to hiring a
secretary.
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Date: Tue, 14 Mar 2000 10:10:40 -0600
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From: Mary Kay Smith <[log in to unmask]>
Organization: Sinai Health System
Subject: Powdered human milk
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The reference to powered human milk has evolved from my "tongue in
cheek" remark about powered blood. I was just trying to be sarcastic
about the attempt to duplicate two body fluids that cannot be
duplicated. Isn't it funny how these things get slightly twisted?
Mary Kay Smith, IBCLC
Romeoville IL near Chicago
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Date: Tue, 14 Mar 2000 10:58:15 EST
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From: Ann Perry <[log in to unmask]>
Subject: biting down
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In the last couple of years I have attended conf where the issues of abnormal
sucking was addressed, sorry I don't have the speakers at hand. What has
been learned at looking at the facial muscles and how the tongue and jaw
work, pulling down on the chin will tighten the biting action not help it.
If you try this on yourself it helps to understand. Pull on your chin and
then feel what happens in the TMJ (cheek) area. These muscles will tighten.
The speakers recommended massaging the TMJ during feedings and between to
help address the biting. I am not an expert on this issue and would love to
see someone on Lactnet who is help explain this.
Pulling on the chin is good for flipping out the bottom lip.
Ann Perry RN IBCLC
Boston, Mass
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Date: Tue, 14 Mar 2000 09:58:50 -0600
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From: Jim & Winnie Mading <[log in to unmask]>
Subject: shield use in hospital
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I agree wholeheartedly with Darlene Breed's comments on whield use
in the hospital. Of course in the ideal situation we wouldn't be
using anything but mom's breast, but as those of us who work there
know, the ideal isn't always possible. When a baby is nursing
through a shield, we need to use the same criteria as when it's
nursing directly. Mom should not feel any pinching; baby should be
exhibiting deep jaw excursions; there needs to be audible swallowing
(although in the first days this can be subtle-the gutteral "eh"
"eh" soung is more common that real gulps and not as obvious without
really listening carefully-with the TV off for example). If these
things are heard and there is milk (colostrum) in the shield
afterwards, there is transfer. When we use a shield, in the
hospital we also have the mom pump for at least 10 minutes each
feeding she has needed the shield. Anything she obtains is given to
the baby in whatever "device" seems to fit the individual mom/baby
situation the best.
Yes, shield use can save a breastfeeding relationship when a mom
might not be amenable to methods we as LC's may prefer. Remember
Linds Smith's rule #2-"The mom is right".
Winnie Mading IBCLC
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Date: Tue, 14 Mar 2000 11:04:43 EST
Reply-To: Lactation Information and Discussion
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From: Carol Brussel <[log in to unmask]>
Subject: clamping down bite
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lisa brings up some good points about evaluating an overly strong suck or
biting or clamping at the breast. i remember my first son was described as a
barracude nurser! pretty good description, too. i won't bore all with the
details of how i was "helped." suffice it to say its a miracle i ever
breastfed him for more than a week (he actually weaned early at almost 3
years).
after eliminating all the other possibilities, and especially after using
compression to speed up milk flow (this can work amazingly well at "fixing" a
poor suck/latch), consider having the baby seen by someone who can do
cranial/sacral work. it can solve this problem, especially if the mother is
unable to do finger feeding for what may be a long while to fix the problem.
i have an alternate theory that doing fingerfeeding for a period of days and
maybe longer, is giving the baby's body time to try to correct what c/s work
can correct more immediately. and, the finger actually in the mouth can do
some of the same work as the c/s techniques.
i do have great concern, though, when i hear the words "apply pressure to the
baby's chin." its hard to know what someone else means by amount of pressure
without a description or qualifier, but applying a lot of counter pressure to
the chin could cause a baby to be more frustrated (depending on why the baby
is compensating in this way, back to lisa's list of suggested causes) or even
lead to an oral aversion instead of helping. occasionally i do find a baby
who is helped by the most minute, tiny amount of pressure on the chin - i
wouldn't even describe it as pressure but more as the presence of the finger,
helping stabilize the jaw.
in most of cranial/sacral work we are taught to use 8 gms. of pressure -
that's the weight of a nickel sitting on your finger. its a very vivid lesson
- holding up a nickel with one finger. to get a better idea of pressure on
the chin, try having someone push down on your chin while drinking something,
then go from there to help the mother understand how much pressure to use.
the dancer hand hold seems to me to be a better support for some of these
things.
and i have, unfortunately, seen plenty of babies whose mothers were taught in
the hospital to push down on the chin and are doing it so forcefully that i
can't blame the baby a bit for not wanting to nurse. and, before the usual
outcry explaining that the mothers are lying, misguided, misinformed, didn't
understand, etc., i will add that i have seen the nurses in the hospitals
teaching it to them as well.
carol brussel IBCLC
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Date: Tue, 14 Mar 2000 11:06:36 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Susan Keith-Hergert <[log in to unmask]>
Subject: Re: sucrose pacifiers as pain relief
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I agree with Kathleen's assertion that a sucrose pacifier is not an acceptable
form of pain relief for surgery. When this "research" first hit the presses
some years ago, I showed it to a nurse practitioner from the Children's Hospital
pain team here. She dismissed it as rediculous. Just because we can get a baby
to suck reflexively and thus inhibit his cry does not mean he does not feel
pain.
Susan
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Date: Tue, 14 Mar 2000 11:16:54 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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Diane signed off....
<< Diane Wiessinger, MS, IBCLC Ithaca, NY, who's cured many a tumble - some
of
them tooth-chipping and bloody - with holding and nursing >>
....and Jan FIRST read it as "cured many a turtle...."
I really DO need new contacts!
Jan B -- in Wheaton
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Date: Tue, 14 Mar 2000 10:16:04 -0600
Reply-To: Lactation Information and Discussion
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From: Jim & Winnie Mading <[log in to unmask]>
Subject: feeding tubes
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I noted in the story about the baby with jaw anomalies that a 5 Fr
feeding tube was used. In my experience I have found the 3.5 Fr
works in most cases (except when the colostrum is quite "thick") and
is less intrusive to the baby. The feeding tubes are rather stiff
compared to the tubes in the SNS's and FingerFeeders which are nice
and soft. That's why I like to use the smallest possible one.
Just a thought, not meant as a criticism.
Winnie Mading IBCLC
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Date: Tue, 14 Mar 2000 11:19:05 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Susan Keith-Hergert <[log in to unmask]>
Subject: Re: NON-HUMAN BOVINE MILK >>>
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My 17 year old, who once told a news reported that it was illogical to drink
something that came from a cows udder, suggested the term "Bovine Lacteal
Secretions." Wonder if anyone would buy that?????
Susan
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Date: Tue, 14 Mar 2000 10:24:35 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Jim & Winnie Mading <[log in to unmask]>
Subject: Percent of shield use
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Off the top of my head, your estimate of 2-3 per hundred births is
probably pretty close, if you take a look over a long period. Why
is it that cetain problems and solutions seem to come in bunches? I
find we go weeks without using a shield and then we get several
situations where it seems to be appropriate. I admit some of this
may be a case of "success breeding success" (it helped with mom "A",
so we're more likely to think of using it for mom "B") but I don't
think that's all of it-in the same way that twins seem to come in
bunches. We've had more in the last month than the previous several
months combined. They were all different gestational ages, too, so
it wasn't "something in the water" at the time they were conceived!
Winnie Mading-from Wisconsin where the weather can't decide what
season it wants to be!
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Date: Tue, 14 Mar 2000 11:24:39 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Susan Keith-Hergert <[log in to unmask]>
Subject: Re: clampdown bite reflex
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I have worked with several clamping/ biting babies who are generally the
products of highly interventive deliveries (deep suction, forceps etc.) I do not
find finger feeds and suck training to be helpful as the more pressure one
places on their jaws the worse they seem to get. I have had success with
referring to an OT/ PT who does cranio-sacral therapy and using a Haberman to
feed until mom can tolerate it.
Did the babe you are working with have a difficult birth?
Susan Keith-Hergert
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Date: Tue, 14 Mar 2000 17:36:51 +0100
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: Normal weaning ages
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> I just had a parent raise an interesting question to me, however. The
> dad said that the AAP's guideline to have *exclusive* breastfeeding
> for the first 6 months wasn't right; he insisted that as soon as the
> infant extends his hand when the food is on the parents' table, the
> infant is ready to eat other foods.
>
I think I just have too much imagination, but this made me giggle. I right away
imagened all kinds off stuff babies of say 3-4 months old reach at when it
caches their attention. Should they eat that all ? The dogs' tail, the
candle-flame, the bunch of keys on a ring, their own toes or other
extremities... :o))
Gonneke van Veldhuizen
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Date: Tue, 14 Mar 2000 11:43:21 -0500
Reply-To: Lactation Information and Discussion
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From: Susan Keith-Hergert <[log in to unmask]>
Subject: Re: Shields versus cups and finger feeds
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Sorry to take so long to respond to this criticism of my earlier suggestion that
babies do not effectively move colostrum with a shield and that shield use might
be reserved for use in moms with a full milk supply.
First of all, I want to say that I am a hospital LC...in an institution that
sees 1500 births a year and has a 70% breastfeeding rate. We have one FTE to
cover this....so I am not walking around on cloud nine somewhere, unaware of
what the "real world of hospitals" is like.
Second, I would like to question what is meant by adequate removal of colustrum
with a shield in place. Are we talking about seeing colustrum in the shield?
Frequent audible swallows? Weight loss of < 10 % at day 4? Milk in by day 4?
Weight beginning to rebound by end of week one? Eight wets and dirties a day?
If someone out there is really seeing all these markers of maternal/ infant well
being, following early introduction of a shield.....I'd be very interested in
seeing your case studies published. I am not saying this to be sarcastic...I
really would like to know.
I have given shields in the hospital for very special and difficult situations
but...never with the above markers being the result. Maybe that is because I am
not giving them out to normal, healthy moms and babies with minor suck problems
that are likely to be resolved. Early introduction of a shield (before mom's
milk is in) has become something I just won't do.
Susan Keith-Hergert RN, MS, CPN, IBCLC
Mercy Health Partners
Cincinnati
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Date: Tue, 14 Mar 2000 10:48:39 -0600
Reply-To: Lactation Information and Discussion
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From: Jim & Winnie Mading <[log in to unmask]>
Subject: Shallow latch
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Forgive me if I repeat-I'm a couple days behind on reading Lactnet
and am responding when I see something I want to react to before I
read all the rest of the digests waiting for me.
I'm sure we all have our own deffinitions for some of the terms we
use. To me shallow latch means the baby isn't getting as much
breast in the mouth as needed to be effective. This certainly
inclused only getting the nipple, but can also include getting just
a little areolar tissue. As we have all seen, areolas (or should it
be areolae?) come in a wide variety of sizes, so getting it all in
baby's mouth is only a guideline for the average size. If it's only
an inch (about 2.5cm for our non-US Netters) baby can obviously get
a lot more in. However if it's 5-6 inches-and I've seen some that
big- there's no way baby can get it all in. One guideline I give
moms is for them to wrap an index finger aroung their nipple and
look at how much areola shows around the finger. Baby needs to have
no more than that amount and maybe even a little less showing when
latched on. Of course, she can't see what's showing on the
underside, so needs to "aim high".
Hope this helps.
Winnie Mading IBCLC
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Date: Tue, 14 Mar 2000 10:48:50 -0600
Reply-To: Lactation Information and Discussion
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From: Kathy Dettwyler <[log in to unmask]>
Subject: Starting solids
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>I just had a parent raise an interesting question to me, however. The
>dad said that the AAP's guideline to have *exclusive* breastfeeding
>for the first 6 months wasn't right; he insisted that as soon as the
>infant extends his hand when the food is on the parents' table, the
>infant is ready to eat other foods.
>
>I was stumped, and could only repeat the AAP's stance. Kathy, do you
>have any thoughts on this? Does this fit with the anthropologist's
>view?
I agree with the father 100% -- watch the baby, listen to the baby, follow
the baby's cues. Have the baby at the table with the rest of the family
when everyone is eating. Have available for the baby appropriate foods
(healthy, high nutrient density, nothing dangerous, nothing highly prone to
be allergic) and offer the baby food to eat on his own (not spoonsfuls of
pureed mush) whenever she or he expresses an interest. It will be the rare
baby who expresses an interest before 4 months, and the rare baby who shows
no interest after 6 months.
I would say that the World Health Organization's infant feeding
recommendations are more useful than the AAPs. The WHO says a 4-6 month
range, rather than the "about six months" of the AAP. One needs to realize
that these recommendations are for people who are otherwise clueless about
when to start a baby on solids, and especially for people who do not, in
general, respect the baby as an individual.
Kathy Dettwyler
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Date: Tue, 14 Mar 2000 10:57:38 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Kathy Dettwyler <[log in to unmask]>
Subject: baby clamping down/forceful sucking
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Something else to consider here is that the baby is really really hungry.
Try feeding more often, along with everything else.
Kathy Dettwyler
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Date: Tue, 14 Mar 2000 10:57:25 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Jim & Winnie Mading <[log in to unmask]>
Subject: Nursing after surgery
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Did you mean a baby who's had surgery or the mom who's had surgery?
Regarding baby-I believe the Lactnet archives has a lot on this.
There was quite a bit of discussion a couple months ago about
whether human milk should be considered clear or full liquid.
Regarding mom-Dr Tom Hale's new book (not the red one but Clinical
Therapy in Breastfeeding Mothers-or something close to that-my copy
is at work) discussed anesthesia. In general as soon as mom is
awake enough to handle aby she should be able to nurse. After all,
why does a person wake up after anesthesia? Because enough of the
drug has left her system that it's no longer having it's effect.
Winnie Mading, IBCLC
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Date: Tue, 14 Mar 2000 11:02:17 -0600
Reply-To: Lactation Information and Discussion
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From: Jim & Winnie Mading <[log in to unmask]>
Subject: OOPS!
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I should reread before responding! I only looked at the body, not
the subject. Certainly moms can nurse after a section. The vast
majority of ours have epidural or spinal morphine so can nurse very
soon-usually as soon as the stitching is done and she's moved to
recovery as long as baby is OK. In those cases where it was a
"crash" section or the epidural didn't "take" and mom had a general,
the guidelines I mentioned apply.
Winnie
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Date: Tue, 14 Mar 2000 17:09:24 +0000
Reply-To: Lactation Information and Discussion
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From: heather <[log in to unmask]>
Subject: Re: sucrose pacifiers as pain relief
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>I agree with Kathleen's assertion that a sucrose pacifier is not an acceptable
>form of pain relief for surgery.
Of course it can't possibly be acceptable - sheesh.
Was this what the original post was about? I just assumed it was heel prick
sorta stuff ....sorry.
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
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Date: Tue, 14 Mar 2000 11:17:51 -0600
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From: Bonnie <[log in to unmask]>
Subject: Feeding tube size..
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To Winnie Mading,=20
Thanks for the suggestion ie: #3.5 Fr tube. I'm not sure if our =
hosp. stocks that size. Next time I'm at work, I'll look it up in the =
stores catalogue and keep your suggestion in mind. No criticism taken. =
I'm on the site to hear suggestions, and to learn. Thanks, Bonnie
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Date: Tue, 14 Mar 2000 11:24:34 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Jim & Winnie Mading <[log in to unmask]>
Subject: Personal biases
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Right on Kathy! It is vital that we keep our own biases out of
professional practice. Of course as Lactation Professionals, we are
quidk to point this out to those who don't, can't, or won't support
breastfeeding. We, too, bring biases into our work. As examples
"Anyone who uses a nippel shield is just too lazy to really work
with the mom" "Cup feeding is the preferred method anytime a baby
isn't nursing" I could go on.
In my own case, I have a strong bias that a woman shoud be married
before having babies. This doesn't prohibit me from working with
single moms. Because I don't agree with their situation doesn't
mean she deserves any less that the best help I can offer. I need
to examine my responses to her so I don't let my belief color my
interactions with her. The same applies for staff who don't "
believe" in the importance of breastfeeding.
Let's not get off on a tangent about married vs single moms-that
doesn't belong on Lactnet. I merely use it as an example.
Winnie Mading, IBCLC-old fashioned in some respects and proud of it
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Date: Tue, 14 Mar 2000 12:27:21 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Norma Ritter <[log in to unmask]>
Subject: Re: More on Mother's Nurser
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I wrote back asking who had given my name and addy..... Mrs.McCoy sent
this reply, without answering my question. Looks to me as if they simply
want an endorsement of their product, at *a name your own price* fee.
Norma
>First, I would like to thank you for responding to my request for help
on my
Small Business Innovation Research (SBIR) Grant, project with NIH. As the
principal investigator my goal is to assemble a team of lactation
consultants to evaluate and test the nursing shield as it is developed.
I
will mail the prototypes with an evaluation sheet for your evaluation.
Your
evaluation will help prepare the nursing shield for commercial use.
Each
shield will be evaluated on overall size and shape, material thickness,
nipple shape and size and color & texture. I have contracted a wonderful
Medical Products Company to develop prototypes. NIH requires that all
consultant who will play a role on my SBIR project submit Biosketches:
These Biosketches (your resume) should be no more than three (3) pages,
however, one (1) page will be greatly appreciated. A sample letter of
what
the commitment letter should sound like is listed below:
Dear Mrs. McCoy
This letter is to express my willingness to serve as a consultant on your
NIH Phase I proposal, "Development of Mothers Nurser Nipple Shield." I
agree to participate for (? Day's? Or Hours? Is your decisions) of
consultation at a minimum rate of ($Your Fee's ? per day or hours.)
Sincerely,
(Your name)
LaTina
________________________________________________________________
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Date: Tue, 14 Mar 2000 11:39:02 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Jim & Winnie Mading <[log in to unmask]>
Subject: Pacifiers / sugar water
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Yes I've heard of this. Apparantly in our NICU they use cherry
syrup to dip them in! Unfortunately, this crept into our holding
nursery (our term for normal newborn nursery-they are supposed to be
in the room with mom so that's where they are "held" anytime they
aren't with her). I posted a comment on this not long ago so it
should be in the archives.
At our WALC (Wisconsin ILCA affiliate) conference recently Linda
Smith cited a study that indicated being help skin to skin with mom
for(I think) 45 minutes before a stressful experience also had an
analgsic effect!
The reference is Pediatrics 2000;105(1)
Winnie Mading RNC, IBCLC
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Date: Tue, 14 Mar 2000 11:44:23 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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Comments: RFC822 error: <W> Incorrect or incomplete address field found and
ignored.
From: Jim & Winnie Mading <[log in to unmask]>
Subject: AWHONN
Comments: To: [log in to unmask]
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I'm not shocked at all. I expect this from AWHONN. I don't think
they ever ascribed to the Code. I just got the info on their
upcoming conference. ABM company references abound regarding
sponsorship of the conference, sessions, receptions, etc.
This isn't to say we shouldn't let them know what we think. By all
means write and just maybe we'll be heard, but the point is they
never claim to be supporters of WHO Code, Baby Friendly, etc.
Winnie
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Date: Tue, 14 Mar 2000 11:44:10 -0600
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From: Marguerite Herschel <[log in to unmask]>
Subject: sucrose
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Sweet taste causes release of endogenous endorphins. Certainly, dorsal
penile nerve block is the standard of care. But if it's between NOTHING and
sucrose, at least give the baby sucrose. We demonstrated the analgesic
effect in our study.
Peggy Herschel, MD
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Date: Tue, 14 Mar 2000 13:47:14 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Re: cream rising to the top
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I think it's not quite as you say, Carol.
["oh come on, now, i thought the milk was constantly being reabsorbed and
remade, which is why the relationship between alcohol in the blood (which is
constantly falling as it is metabolized) and alcohol in the milk stays the
same and you don't have to pump and dump (how i hate that phrase, makes milk
sound like toxic sludge)."]
Once the milk is made, it stays made and stays in the ducts and sinuses. But
some chemicals in the milk, like alcohol, can go either way through the cell
walls, so as blood alcohol level drops, the milk alcohol travels to the area
of lower concentration while the milk stays behind.
I think the notion of the cream rising within the breast---although I did
once whimsically suggest that might happen---is pretty far-fetched. To my
mind, there's a big difference between a passive container, like a bottle of
milk on your doorstep or in your refrigerator, and a dynamic milk-generating
living system, like a lactating breast.
Peace to all,
Chris Mulford
Swarthmore PA USA
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Date: Tue, 14 Mar 2000 14:09:20 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: sucrose pacifiers
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Peggy, this discussion has raised another question. Did you compare -- or as
far as you know does anyone have any data that could be used for comparison
-- between babies who got that sucrose suck 20 minutes before some procedure,
on the one hand, and babies who were held and nursed, as Diane points out,
before?
I guess lots of people who do circs won't agree to a full tummy before they
start, and so for those poor babies the sucrose before could go along with a
quick trip to breast right after. But certainly for heel sticks, etc, if
nurse-and-hold works as well -- and it does seem intuitive that it would work
*at least* as well, though data would be nice -- then sucrose pacifiers would
be de trop, at least for bf babies.
Any thoughts?
Elisheva Urbas
NYC
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Date: Tue, 14 Mar 2000 11:11:22 -0800
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From: Venus <[log in to unmask]>
Subject: Re: Vermox
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Thanks to everyone who responded so promptly regarding vermox. The
mum has decided she will go ahead and breastfeed anyway and your
responses have made her feel MUCH better about that decision! :)
Thanks again
Jennifer Landels, BA, CBE
Vancouver BC
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Date: Tue, 14 Mar 2000 14:18:57 EST
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From: [log in to unmask]
Subject: Re: Looking for an L.C.
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Hi,
Trying to find a lactation consultant who can help a Mom living in Milan,
Italy who
would be able to talk to the mom in english. She is having problems nursing
her
baby and will probably be going home from the hospital in the next couple of
days.
Home and the hospital are both in Milan.
Thanks for your help.
Tammy Arbeter - Tammyarb.aol.com
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Date: Tue, 14 Mar 2000 15:07:10 -0400
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From: Marilyn Norton <[log in to unmask]>
Subject: Re: clamping
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It may help to put this baby to breast when he is barely awake, before he
can "think" what he's doing. Also, did this mom have an epidural/difficult
delivery. I have seen this occasionally - time, patience, pumping and finger
feeding for a few feeds seems to help.
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Date: Tue, 14 Mar 2000 16:36:09 -0400
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From: Marc Lussier <[log in to unmask]>
Organization: Markel Industries
Subject: references for pumping guidelines
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Hi Lactnetters,
Does anyone have references for indicating that a mom who is unable to
breastfeed after the birth of her baby, should pump within 6 hours?
Hill, et al. 1995, recommends using the 6 hour cutoff, but they do not
cite a reference for this. Others cite Hill et al. for this
recommendation. I am aware of the research that provides evidence of
the connection between early and frequent feedings and adequate milk
supply, but nothing that distinguishes this 6 hour marker and pumping.
TIA for your help.
Sincerely,
Mary M. Lussier BSN IBCLC
Hartford, CT.
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Date: Tue, 14 Mar 2000 16:21:07 +0100
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From: Rachel e-mail <[log in to unmask]>
Subject: Australian position
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On the IBFAN BF calendar for 2000, the December photo is from Australia.
Could those of you have the calendar please let us know whether it is a =
depiction of the Australian position, or perhaps a variation on the =
theme?
I can't tell who is on top or which breast the child is taking. If that =
doesn't pique everyone's curiosity to go find the IBFAN site and order a =
calendar, then I can't help it.
It is a terrific picture!
clowning around at my PC getting ready to go to Amsterdam for a home =
birth conference, :-)
Rachel in Kristiansand [log in to unmask]
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Date: Tue, 14 Mar 2000 17:06:55 -0500
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From: Robert Cordes DO <[log in to unmask]>
Subject: every 45 minutes
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I hate it when I lose things.
Can someone let me know were on the web I can find the poem "So I nursed him
every 45 minutes"?
thanks,
Rob
Rob Cordes, DO, FAAP, FACOP
general pediatrician
Wilkes Barre PA
mailto:[log in to unmask]
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Date: Tue, 14 Mar 2000 15:07:18 -0700
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From: Jill Andrews <[log in to unmask]>
Subject: hydrocephalus an OTR perspective
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I agree with all the responses to this. My thought was that their were two
issues going on here. The first being the therapist uncomfortable with the
extended nursing which was addressed superbly.
But if the baby is nursing throughout the therapy session I too would be
very frustrated. I therapist has very limited time to evaluate, treat, talk
to the mom, talk to the other therapist, and do all the documentation.
Although I can sympathize with the mom wanting to comfort the child, the
therapists may need the entire session to help the child. A lot of
developmental therapy is based on a progression of tasks that need a certain
flow so to speak to work.
Just my 2 cents.
Jill Andrews OTR
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Date: Tue, 14 Mar 2000 23:11:55 +0100
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From: Rachel e-mail <[log in to unmask]>
Subject: found phone
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I am off to Amsterdam, nomail, to think about breastfeeding in the =
context of holistic maternity care. The cordless phone was in my =
daughter's coat pocket, so it wasn't just prolonged irreversible BF =
fogginess that made it so hard for me to find it. Thanks to all who =
sent me support during my temporary handicap.
Rachel --who is taking her brand new snazzy lap-top to the homebirth =
conference-- watch out!
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Date: Tue, 14 Mar 2000 18:33:06 EST
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Subject: Looking for Jean Ridler
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Dear Friends:
Would Jean Ridler (of Bellville, South Africa) please email me privately?
I have lost her email address.
Thank you.
Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI, CSTP
Elkins Park (a suburb of Philadelphia, Pennsylvania; northeastern USA)
supporter of the WHO Code and the Mother Friendly Childbirth Initiative
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Date: Tue, 14 Mar 2000 19:15:09 EST
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I have a question. Are there any IBCLC who are not RN's that are working in a
hospital. If so could you Email me privately. Thank you
Maria Winschel, IBCLC Naples FL [log in to unmask]
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Date: Wed, 15 Mar 2000 10:39:33 +1000
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From: Denise Fisher <[log in to unmask]>
Subject: percentage of shield use
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Here's some very good stats for those interested. King George V is a very
large and busy maternity hospital in Sydney Australia. They have a
Lactation Team which sees breastfeeding problems. Please note that these
statistics apply ONLY to women referred to the team with problems - NOT to
all women who delivered at the hospital.
1218 women (inpatients) were referred to the team with breastfeeding problems
a nipple shield was considered necessary for 44 women (3.6%)
quote "once the milk was in"
<snip> talks about appropriate instruction and followup
7 mothers were followed up elsewhere - 37 returned to the team.
Av age at outpatient visit: 11 days
Reasons for nipple shield use:
1 - inverted nipples
7 - sore nipples
7 - in-coordinate suck
22 - difficult to latch
Weight at followup (note: all these women were very well taught and had
several breastfeeds observed by experienced LCs prior to discharge)
53% gained weight (25 -325g)
25% lost weight (20 - 190g)
22% remained unchanged
(Sorry US-ers, to convert to ounces divide by 30)
All babies were tried without the shield from the commencement of the feed
at the follow-up visit.
Cessation of nipple shield:
5.4% prior to visit
59.2% from 1st visit
19% within 1st week of visit
11% within 2nd week of visit
5.4% continued to use the shield
I think those stats speak volumes.
Denise
Brisbane, Australia
****************************************************
Denise Fisher, BN, RM, IBCLC
BreastEd Online Lactation Studies Course
http://www.breasted.com.au
mailto:[log in to unmask]
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Date: Tue, 14 Mar 2000 17:00:34 -0800
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: 6 hour pp pumping
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Mary: Lots of the "LCs" (not necessarily IBCLCs) around here seem to
believe in that 6 hour rule of pumping (as though it were a religious
tenet). Personally, I think pumping this early is actually distruptive as
it can both undermine mom's confidence and can cause inflamation. IMNSHO, I
give 48 hours of repeated responding to the baby's cues, lots of skin to
skin contact (yes, taking mom's shirt off even in the hospital) and mega
amounts of patience and faith that the process works most of the time
without gadgets. Just having baby rub up against nipples repeated, perhaps
licking here and there, appears to be extremely effective. (Of course we do
lots of things to muck this up with drugs, separation, even clothing, etc.)
IF this hasn't worked (and if I'm there early, no bottles have been given,
etc., it almost always does), then I resort to pumps or other means unless
the mom is showing signs of very early engorgement.
One thing, among many, that my past years of LLLI involvement taught me was
to have faith in women's bodies. When WE have faith, it rubs off on moms
and other hcps. I cannot tell you how many times I've had hospital RNs say
"that mom will never nurse" (yes, in front of the moms) and we've turned it
around. In those early hours (up to say 48 hours) we have the luxury of
learning to "dance". I just cry when I see people hitting the panic button
so early and starting that downward spiral. There IS a time for
intervention, but I'd have to see some serious data before I'd think it was
at 6 hours.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, author, organic
gardener, photographer, lapidary creator, lousy cleaner.
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Date: Tue, 14 Mar 2000 20:06:23 -0500
Reply-To: Lactation Information and Discussion
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From: Janet Vandenberg <[log in to unmask]>
Subject: Re: So I nursed him every 45 minutes
Comments: cc: Robert Cordes DO <[log in to unmask]>
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Rob,
Elizabeth Baldwin's article can be found at:
http://www.naturalchild.com/guest/elizabeth_baldwin.html
I also found this lovely picture of Elizabeth on her law firm's web
site:
http://www.baldwinandbaldwin.com/elizabeth.html
Janet Vandenberg RN, BScN, IBCLC
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Date: Wed, 15 Mar 2000 11:08:23 +1000
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From: Denise Fisher <[log in to unmask]>
Subject: hospital policies
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Speaking from my limited knowledge of the law...
A hospital policy is a legal document. If a staff member does not follow
the hospital policy (on anything) and the hospital gets sued - then that
hospital won't support the person who did the anti-policy action. ie they
are absolved from vicarious liability.
If nothing else works try that line with the nurses.
And I'm really not saying that in jest. I mean it is really serious not to
follow hospital policy on something. I would be very scared.
Good luck
Denise
****************************************************
Denise Fisher, BN, RM, IBCLC
BreastEd Online Lactation Studies Course
http://www.breasted.com.au
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Date: Tue, 14 Mar 2000 20:30:16 EST
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From: Carol Brussel <[log in to unmask]>
Subject: mother's nurser
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well, norma, i suppose one could name a high price, evaluate the product
according to one's expertise and knowledge (and i wonder how one would rate
such a product? thinking of course of how it sounds already), donate the
money to a truly breastfeeding supportive charity and see that the chips fall
where they may?
with only this tiny bit of knowledge about this product i can make all kinds
of assumptions (all bad). maybe it would ruin its chances of getting approved
for sale.
of course, that probably wouldn't happen, a good person's name would be
ruined by association with a sleazy product, and it will probably turn out
that some reputable company that we previously thought was decent will be the
one that is making and marketing it. sigh.
carol brussel IBCLC
living cynical in denver, CO
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Date: Wed, 15 Mar 2000 09:54:54 +0800
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From: Joy Anderson <[log in to unmask]>
Subject: Maternal osteogenesis imperfecta
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Hi all,
Had a query from a fellow NMAA Counsellor. I have tried to find stuff
in the archives about this, but it seems what was discussed earlier
was in the baby, not maternal.
>Has anyone had experience with the following situation?
>
>A breastfeeding mother with osteogenesis imperfecta (ie brittle bones). The
>baby has not inherited the condition. The mother has been advised to wean
>at 3 months.
Kathy Dettwyler posted a URL for info on this condition, and that was
quite useful, but did not directly address the situation of
breastfeeding, when the mother has the condition.
The section on osteoporosis mentioned that low oestrogen after
menopause was thought to contribute to fractures, so they recommend
these women take HRT. I wonder if the doctor in this mother's
situation is concerned about low oestrogen levels during lactation. I
thought maybe (just surmising here) he reckoned that 3 months'
breastfeeding was a reasonable compromise for the baby to get a good
start but minimise the low oestrogen levels in the mother. What do
you all think? The mother would like to keep breastfeeding if she
could.
TIA
******************************************************************
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: Tue, 14 Mar 2000 18:03:22 -0800
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: 6 hour pp pumping & finger feeds
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Alicia: You're welcome...I'd say your approach follows the same line that I
have been using.
"> Chris: Thanks for your well-thought-out response about pumping too
early.
> What's your opinion about mother hand-expressing gently and finger-feeding
> spoonfuls of colostrum to the non-latching baby? It would seem to me that
> this, along with skin-to-skin and nuzzling, etc, may not have the same
> negative effect on mother's confidence that pumping might have. In some
> cases, I think it may help her gain confidence since she can feed the
> precious colostrum to the baby (and avoid hypoglycemia, jaundice, etc). I
> have learned a lot from your posts. Regards, Alicia Dermer, MD, IBCLC."
IMO, Hand pumping (if instructed--I use Marmet's tech with the LLL tear off)
and finger feeding or even dripping the colostrum onto/down the breast is
far better because it improves skin-to-skin and helps the confidence factor
by not relying on a pump. I'm sure this will ignite a firestorm though...it
would here
locally. We seem to have two camps here--very interventionist with little
faith in human function and totally laissez faire (sp?) where nothing but
natural goes. Hopefully, I fall somewhere in the middle, but
self-evaluation is tough.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, author, organic
gardener, photographer, lapidary creator, lousy cleaner.
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Date: Tue, 14 Mar 2000 21:10:16 -0500
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From: "Catherine Watson Genna, IBCLC" <[log in to unmask]>
Subject: Re: Shallow latch
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Shallow latch signs from the outside:
- baby's chin and nose are not resting on the breast (though if they
are, you can't take it for granted that the latch is deep enough, mom
may have just pulled baby against the soft breast)
- lips are pulled inward (sign that baby was closing mouth as he came to
breast)
- lips are flanged so much they are doubled over - and often the lips
are doing the sucking instead of the tongue. Excessive lip movement is
a signal the latch is shallow.
- dimpling of the cheeks during jaw opening means there is too much
airspace in the mouth, in other words, it is not full of breast as it
should be. (potential confounder-this may occur in premies due to
reduced fat pads as well.)
- nipple comes out beveled and with a compression stripe (looking like
an unused lipstick).
- maternal pain.
--
Catherine Watson Genna, IBCLC New York City mailto:[log in to unmask]
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Date: Tue, 14 Mar 2000 21:10:22 -0500
Reply-To: Lactation Information and Discussion
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From: "Catherine Watson Genna, IBCLC" <[log in to unmask]>
Subject: Re: Normal weaning ages
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Marie,
I know I'm not the Kathy you meant, but I usually tell parents that when
the baby can sit, pick up the food, get it into his/her own mouth, and
chew on it, he/she is developmentally ready for solids.
--
Catherine Watson Genna, IBCLC New York City mailto:[log in to unmask]
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Date: Tue, 14 Mar 2000 21:10:31 -0500
Reply-To: Lactation Information and Discussion
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From: "Catherine Watson Genna, IBCLC" <[log in to unmask]>
Subject: Re: letters from moms
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I liked Chris' term "warm fuzzy file". I keep an album with the letters
and photos and holiday cards from my "Mommies". When it was a bad week
(like when a pedi told one of my clients that I refer infants for
evaluation of their frenula because the surgeon gives me kickbacks- sooo
not true) or too many moms quit breastfeeding and I think my competence
is waning, I pull out my album. Aah!
--
Catherine Watson Genna, IBCLC New York City mailto:[log in to unmask]
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Date: Tue, 14 Mar 2000 21:10:46 -0500
Reply-To: Lactation Information and Discussion
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From: "Catherine Watson Genna, IBCLC" <[log in to unmask]>
Subject: Re: Journal Club #2
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Sharon,
I agree with you that yeast is overdiagnosed on the basis of deep breast
pain.
--
Catherine Watson Genna, IBCLC New York City mailto:[log in to unmask]
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Date: Tue, 14 Mar 2000 21:10:57 -0500
Reply-To: Lactation Information and Discussion
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From: "Catherine Watson Genna, IBCLC" <[log in to unmask]>
Subject: Re: journal club #2
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I have been looking over my client records since I read this study, and
have found that many women who had cracked nipples did indeed aquire
mastitis. Usually I saw some redness or palpated induration or adeas of
increased consistency on the breast and "saw it coming" and gave
appropriate advice to try to fend it off or obtain early medical
treatment if it progressed. I might be a little faster to encourage
mothers with incipient mastitis to see their physicians, rather than
taking a wait and see attitude after reading this study.
However, a major weakness here is that there was no follow-up of the
mothers with negative nipple staph cultures, so we can't take for
granted that every cracked nipple has staph as the authors seem to
conclude, or that every cracked nipple is going to progress to
mastitis. This is a great topic to continue this very interesting
research, as well as following antibiotic treated moms to see if there
is an increased prevalence of candidiasis.
I thought it particularly interesting that such a large proportion of
the infants of these mothers with staph aureus infections had
retrognathia or tongue tie, which are prevalent problems in my client
population. Better screening of infants after birth for these
difficulties would allow us to give these moms extra assistance with
breastfeeding, and perhaps prevent nipple damage and the resultant
infections.
Finally, I would be interested to know where these women delivered.
Staph aureus is a common pathogen in hospitals. I wonder if
particularly virulent strains are being introduced into the babies'
mouths during procedures surrounding the birth. Jan Riordan speculated
in her old book for nurses (sorry, forgot the title) that introducing a
finger or suction tube into an infant's mouth before the maternal breast
could innoculate the "germ free" infant with hospital organisms rather
than the family normal flora. Makes perfect sense to me. I have rarely
seen a case of mastitis in my clients who have had homebirths, even with
a tongue-tied infant and cracked nipples.
What do you all think about these issues?
--
Catherine Watson Genna, IBCLC New York City mailto:[log in to unmask]
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Date: Tue, 14 Mar 2000 21:11:04 -0500
Reply-To: Lactation Information and Discussion
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From: "Catherine Watson Genna, IBCLC" <[log in to unmask]>
Subject: Re: thoughts on "Australian" position
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This position works well for babies who have airway stability issues
such as Pierre Robin babies.
Never say never! ;-}
--
Catherine Watson Genna, IBCLC New York City mailto:[log in to unmask]
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Date: Tue, 14 Mar 2000 21:11:18 -0500
Reply-To: Lactation Information and Discussion
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From: "Catherine Watson Genna, IBCLC" <[log in to unmask]>
Subject: Re: biting down
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Biting down while sucking is usually a result of either reflex or
compensatory movements due to tongue instability.
Reflex: when the tongue is not covering the lower alveolar ridge (gum),
and something touches it where the teeth are/will be, the phasic bite
reflex is initiated. Look for tongue tie.
Compensatory:
1. low tone kids sometimes 'fix' (use excessive muscular force and
duration of contraction) their tongue or jaws in an effort to overcome
the tone problem, resulting in biting.
2. a shallow latch will destabilize the tongue, causing compensatory
excessive compression of the nipple, which feels like biting.
3. a tongue tie can cause any of the above, as well as prevent the
tongue from elevating against the breast, again leading the baby to
overuse compression with the jaw instead.
4. a baby who is slipping off the breast due to a shallow latch will
use compression to try to stay on. For #2-4, improve the latch, for #1,
improve the child's body positioning and stability, for reflex biting,
look for tongue tie or respiratory difficulty that might lead to tongue
retraction and address that.
I'm sure I posted on these issues in more detail, but never codified it
like this before. Yo can always search the archives, I've had the same
email address for years!
--
Catherine Watson Genna, IBCLC New York City mailto:[log in to unmask]
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Date: Tue, 14 Mar 2000 21:12:08 -0500
Reply-To: Lactation Information and Discussion
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From: "Catherine Watson Genna, IBCLC" <[log in to unmask]>
Subject: Re: Lipase & Lactase
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Isn't it glucose and galactose?
--
Catherine Watson Genna, IBCLC New York City mailto:[log in to unmask]
[log in to unmask] wrote:
>
> Pat clarifies....
>
> << Lactose is a disaccharide found in breast milk.
>
> Lactase from the gut is what breaks lactose down into dextrose and
> galactose.
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Date: Tue, 14 Mar 2000 21:12:22 -0500
Reply-To: Lactation Information and Discussion
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From: "Catherine Watson Genna, IBCLC" <[log in to unmask]>
Subject: Re: breast pain post yeast
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Rob,
Look at the baby's latch. If it is shallow, that destabilizes the
tongue and the baby will compensate by increasing jaw compression. In
other words, he will bite strongly, causing nerve compression and nipple
ischemia. Check out the archives under nipple compression syndrome, and
teach mom how to help the baby latch more deeply. Also look at the
possibility of dermatitis secondary to the topical treatments.
--
Catherine Watson Genna, IBCLC New York City mailto:[log in to unmask]
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Date: Tue, 14 Mar 2000 21:15:28 -0500
Reply-To: Lactation Information and Discussion
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From: "Cindy Curtis, RN, IBCLC" <[log in to unmask]>
Subject: Re: Leaking device
Comments: cc: [log in to unmask]
I think that you are talking about Blis {Breast Leakage Inhibitor
System}.... I just ran across their info in office files today, here is the
web page,
http://breastfeeding.hypermart.net/blis.html
Cindy
Cindy Curtis,RN,IBCLC
mailto:[log in to unmask]
http://www.erols.com/cindyrn
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Date: Tue, 14 Mar 2000 21:31:40 EST
Reply-To: Lactation Information and Discussion
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From: Kathy Parkes <[log in to unmask]>
Subject: Nursing Corsett listed on ebay
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Here is a real find, and so interesting to see.
http://cgi.ebay.com/aw-cgi/eBayISAPI.dll?ViewItem&item=279430800
A corsett for nursing mothers in the 1920's!!
Kathy Parkes, RN, IBCLC
The Lactation Connection (TLC)
www.tlc4moms.com
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Date: Tue, 14 Mar 2000 21:42:21 -0500
Reply-To: Lactation Information and Discussion
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From: "Cindy Curtis, RN, IBCLC" <[log in to unmask]>
Subject: Re: every 45 minutes
Comments: cc: Rob Cordes <[log in to unmask]>
Here is the URL :
So I Nursed Him Every 45 Minutes
http://www.naturalchild.com/guest/elizabeth_baldwin.html
Cindy Curtis,RN,IBCLC
mailto:[log in to unmask]
http://www.erols.com/cindyrn
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Date: Tue, 14 Mar 2000 18:55:43 -0800
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: lack of community and hcp support
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Dear Friends: I write to you asking for some lactation politcs support and
advice. It greatly saddens me that the 5th IBCLC in 5 years has just been
run out of town (one chose to leave for a position further away and more
work for same pay). Our University town, with its 50,000 people, has no OB
floor lactation consultants in the only hospital in town. I am the only
private IBCLC here, but there are several others--one works for a local OB
group and the rest for home health seeing patients immediately pp at home.
Over weekends, nights and holidays, I get bombarded by calls and if I can't
take them; many moms have to drive to the next town (about 25 minutes).
When I moved here in 1992, there actually was a hospital-based lactation
program, but it and the breastfeeding task force were dismantled 2 years
later. We have two vibrant and active LLL groups with several Leaders. Our
local health dept. (I'm vice chair of the board) says it supports
lactation, but hasn't provided reasonable funding for classes or follow-up
for their WIC clients. I see many of their patients either on a sliding
scale or free. The well-trained IBCLC, RN who had just joined the Health
Dept. about 5 months ago has just recently left under discouraging and
bizarre circumstances (she's on LN and may choose to divulge the details).
When any of us, private LCs, the taskforce, LLL, etc--have requested
resources (additional funding or even space for meetings) from either the
hospital, health dept, local foundation, or a local hcp network, we have
been rebuffed with the excuse that "there are sufficient resources in this
community and no evidence that additional lactation servcies would do any
good or are even needed)." So, it is out of frustration that I write to you
asking what would YOU do to improve services and raise the priority of bf
here? TIA!
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, author, organic
gardener, photographer, lapidary creator, lousy cleaner.
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Date: Tue, 14 Mar 2000 22:16:53 EST
Reply-To: Lactation Information and Discussion
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From: Mary Schultz <[log in to unmask]>
Subject: Re: LACTNET Digest - BF after C/S
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<< Is it common hospital policy/practice to not allow BFing in surgery or
recovery? Thanks in advance for any insight into this issue. >>
I think that all depends on the hospital....the one I primarily work at
encourages it, and another in the area does too. In fact, I had the pleasure
and privilege of acting as an labor coach/doula just last weekend for my
brother and his wife--who ended up with a C/S under general anaesthesia. The
staff was very short handed, and asked me "are you any good with
breastfeeding? Your sister-in-law should breastfeed as soon as she's able to
in the recovery room." I modestly responded that I thought I could handle it
(LOL) and would be delighted to--so there's one positive response, at least!
Mary Schultz, MD
Peoria, IL
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Date: Tue, 14 Mar 2000 22:27:59 -0500
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From: Pam Wiggins <[log in to unmask]>
Subject: Re: pain in infants
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I never needed a pacifier to relieve pain. I always caused a stir in the
pediatrician's office when I insisted on putting my babies to breast when
they got their shots. Worked every time. Maybe a slight jump and increased
sucking when the needle stuck, but that's all. No crying.
Pam Wiggins, IBCLC
Franklin VA 23851
www.lapub.com
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Date: Tue, 14 Mar 2000 22:31:33 EST
Reply-To: Lactation Information and Discussion
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From: Kermaline J Cotterman <[log in to unmask]>
Subject: Cream/position (long)
Comments: cc: [log in to unmask]
Well, Denise, at least we are disagreeing without being disagreeable.
(And I know all too well how disagreeable night duty can make one feel,
having spent over a dozen years on nights in the past.) Your comments
will definitely stimulate me to go back and read more carefully for
further understanding. But to answer some of the questions you raised:
< So,
by 'leaked', you mean released into the milk?>
No. I mean leaked out the nipple between feedings into the mother's
nursing pads and discarded. I hear plenty of moms complaining (or
bragging) about going through boxes of nursing pads in a week.
<Two 'musings' here: if it hasn't been released (?leaked) then it is
still
adherent to the walls of the alveoli and ductules, therefore it isn't
'mixed with the skim'.
Let's say though that baby was 'half way' through 'emptying' that breast
and wanted no more. So the milk was definitely not 'skim'. >
Perhaps for the purpose of this present discussion, it would be better if
I used the term " aqueous portion of the milk", in which all components
except the fat globules are actually dissolved.
While in the example above, there may not be "technically" skim milk,
once the fat globules have been released and dispursed forward in the
breast, I don't see how it can be other than at least mixed in with the
aqueous portion for an hour or more after a feeding, and therefore,
wasted in any leakage out of the breast.
Many moms here, especially if raised in the city, are only familiar with
"milk" as like what they have been drinking since they can remember
(whether they drink 1%, 2% or 3 1/2%, it has all undergone
homogenization), Or, thinking of milk they've seen given to babies, they
are equating it with formula, which does not separate either, probably
for the same reason.
The younger they are, the less understanding most of them have that milk
in its natural state separates into aqueous and milkfat portions. They
have been exposed, however, to the concepts of "skim", "low-fat",
half-and-half and whipping cream, as separate products in the dairy case.
I take advantage of this by using the words "skim" and "cream" in
explaining some of their questions about the color of their milk, the
baby's behavior and stool pattern, etc.
<What happens to
that fat if baby doesn't return to that breast to feed for say another 5
hours? My understanding is that it re-adheres to the alveoli and ductule
walls again.>
I cannot conceive of the same globule of cream ("that fat"), once having
been let down, ascending back up again into a ductule or alveolus, (since
there is no "let-up" reflex to squirt it back through the narrowest
tubing!)
Strict terminology that I have been reading uses the word "ductule" only
for the smallest branch of the duct system, immediately off the alveolus.
The word "duct", perhaps modified by "smaller" or "larger" or "major"
etc., is used for all other tubings in the duct system, I believe.
So while I can see it beginning to migrate slowly toward the walls of the
nearest duct, I still visualize specific gravity also causing it to float
slowly in the direction of the ceiling till it contacts a duct wall or
other globules adhering to a duct wall. But the mother's vertical or
horizontal position, if stable, as in sitting and standing, versus lying
still for several hours, plus the "hang" of her breast, would have some
small effect on where "ceilingward" would make some individual fat
globules end up.
Since most moms spend perhaps as much as 2/3 of the 24 hours vertical, my
assumption then is that most of the fat that has made it past the barrier
of the tiniest tubing into the larger, more distant ducts will float
upward as far as possible, but not re-enter the actual ductules.
And the longer she goes between MER's, the more chance for obvious
separation to occur in the milk stored in the ducts. The longer the
tubings in her breast (generally C cup and beyond), the more aqueous
would be the portion closest to the nipple, and the further away in the
duct system the fat globules would have floated. I sometimes wonder if
breast massage and compression might help "mix it up" a little even
before it stimulates an MER.
I find this line of reasoning, this "model in my head" definitely helpful
to ME (emphasis) when signs of lactose overload, overactive MER, and
overabundant milk supply seem to be present. Perhaps I oversimplify it
for the mothers (I can hear my friends say "Jean? Simplify anything?
Perish the thought!"). But many moms seem to see the point in the way I
explain it and are thereby empowered to manage their feedings a little
differently if they so desire.
But as you say, it probably doesn't make a whit of difference in a 24
hour time period. Perhaps I am belaboring the point, sort of like
debating how many angels fit on the head of a pin. As you say, we need
only to have another MER or two and there would be a different mixture in
the next "batch" anyway.
<Why teach a mother something that is only ever useful for such a brief
time. >
Oh, but how vulnerable I find they are with early dismissal and
especially during those first 2 or 3 weeks home! Sleep deprivation in the
early weeks is one of the primary reasons I find the lower-income and/or
less educated mothers (yes, and fathers and significant others too)
turning to formula for at least a little respite, starting the downward
spiral of "too little milk so I gave him another bottle".
<And side lying in bed gives mother the rest and all the other advantages
of
lying down without risking the lousy drainage that this position affords
the breast at such a crucial time in establishing her lactation.>
Many of them here are so confused over the issue of co-sleeping by now
that they are afraid to try to nurse at night in side lying position. I
will admit that this is the first I have heard that drainage in this
position could be termed "lousy". I was operating on the assumption that
the mom is developing a good MER. Or if she has an especially strong one,
a few night time feedings in this antigravity position might even be
beneficial.
I would particularly like to hear the experiences and opinions of others
about recommending this position for occasional use when the mother is
"craving" sleep in the early days.
Craving sleep now,
Jean
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K. Jean Cotterman RNC, IBCLC
Dayton Ohio USA
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Date: Tue, 14 Mar 2000 23:09:43 -1000
Reply-To: Lactation Information and Discussion
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From: Pam Easterday <[log in to unmask]>
Subject: lack of community support
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Chris asked what can be done to make a community's health care providers
support breastfeeding. The customers are most likely to have an impact.
Try to learn where to direct requests/demands/complaints. A local doctor
told me that mothers' letters to the hospital would be trashed. They should
write letters to the town NEWSPAPER instead.
I encourage moms to educate everywhere they go. Tell their doctors how
often they really nursed. Show him or her the book or reference that was
helpful. Reveal who helped. Fight the insurance company rejection. Tell
the formula carrying nurse, "no."
The mothers you help also teach and support their neighbors, sisters and the
lady they don't really know in church. Good is contagious.
We still have a million miles to go, but it helps my attitude to see all
that we do accomplish.
Keep up the good work, Pam Easterday LLLL Ohio USA
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Date: Tue, 14 Mar 2000 20:17:49 -0800
Reply-To: Lactation Information and Discussion
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: Re: LACTNET Digest - 14 Mar 2000 - Special issue (#2000-332)
Comments: cc: [log in to unmask]
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Cathrine: Glucose and Galactose are both sugars. I think our discussion
was about which enzyme was active and I think we settled it (or rather Kathy
did) with Lipase (the enzyme which acts upon Lipid, thus speeding the
breakdown process and causing rancidity).
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, author, organic
gardener, photographer, lapidary creator, lousy cleaner.
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Date: Tue, 14 Mar 2000 20:32:12 -0800
Reply-To: Lactation Information and Discussion
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: Pure Essentials? Cabbage Gel
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Has anyone seen or know where I can find Pure Essentials Cabbage Gel? A few
years back, when it was new, they sent me some samples. I grow my own
organic cabbage for use with moms, so I didn't use it. Recently, I
rediscovered the gel packs and used them (one on my stabbed hand that
swelled big time) and just anecdotally of course, it worked. TIA!
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, author, organic
gardener, photographer, lapidary creator, lousy cleaner.
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