Greetings,
I am working as a IBCLC at a small hospital in Maryland. I simply offered
my services to the Community
Education Department to teach breastfeeding classes, that got my foot in the
door. About 3 years later it has grown into a Breastfeeding Resource Center
and I provide outpatient services, support group, pumps, and telephone
support, classes, staff and community ed. Baby steps. Establish yourself
and the need for services, do a great job, and the "not a nurse" thing goes
away as the respect for all you know and how professionally you conduct
yourself takes over.
Good Luck,
Lori Werrell, BA, IBCLC
Leonardtown MD
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Date: Tuesday, March 14, 2000 19:15
Subject: LACTNET Digest - 14 Mar 2000 - Special issue (#2000-330)
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Date: Thu, 16 Mar 2000 13:49:17 EST
Reply-To: Lactation Information and Discussion
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Jeanne says,
<< Really, based on physiology of lactogenesis, we have two weeks for milk
production to proceed, so what's the hurry?? >>
Does anyone know if there are any GOOD studies out there that look at timing
of the first feed/pumping with (a) severity of engorgement (the later the
first feed/pumping the more severe the engorgement) or with milk supply down
the road -- around 3 to 5 months. I'm concerned with mothers who think they
"lose" their milk at 4 months (this is particularly an issue with Ezzo-type
moms who are scheduling their babies from the get-go -- not all, of course,
but enough to warrant a second look). I've found that milk supply in these
women doesn't necessarily respond to increased feeds, pumping, herbal
galactogogues or Reglan. I've wondered how much postponing pumping or the
initial GOOD breastfeed plays a role in that. Anyone know?
Jan B
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Date: Thu, 16 Mar 2000 19:07:51 +0100
Reply-To: Lactation Information and Discussion
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: mittens
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> Why do babies wear mittens indoors? Here, they wear them because the
> parents worry about the baby scratching himself - in fact the indoor
> mittens we buy here are called 'scatch mitts' - no idea if you have them
> anywhere else
In The Netherlands oldfashioned like baby clothes consist of under and over
nappies and under and overshirts, the latter with extra long sleeves to be
pulled over the hands and pinned together, in order to prevent the baby from
scratching himself. i've been told that some people think (thought) that a
babies' fingernails could not be cut of untill a certain amount of weeks (6?)
I indeed have seen babies fuss to get those fingers out of the sleeves and
become more stressed by doing so then they perhaps would have been by an
occacional scratch.
And I think Heather is right in assuming that the way some parents react to the
responsibilities of parenthood may cause breastfeeding problems. I think the
fussiness of the baby to get rid of the mittens can play a role as well.
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
http://www.users.skynet.be/eurolac
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Date: Thu, 16 Mar 2000 14:56:13 -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: Serzone?
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I have a friend who recently was precribed Serzone for depression. Lacking
Internet access, she asked me to research the drug for her, and this is what I
found. Please note that the *** emphases are mine, not from the monograph.
~~~~~~~~~~
Nefazodone (Serzone/Bristol-Myers Squibb) is a serotonin reuptake inhibitor
structurally related to trazodone. The drug also appears to block postsynaptic
serotonin receptors. In comparative studies of patients with major depression,
nefazodone proved more effective than placebo and better tolerated than
imipramine. It has little effect on hemodynamics and is less sedating than other
antidepressants.
Nefazodone has some interesting effects: it raises oral temperature, causes a
***dose-related increase in prolactin levels***, increases REM sleep, and has
shown analgesic activity (it may be a useful adjunct in pain management).
Although nefazodone is nonsedating and does not appear to potentiate the
depressant effects of alcohol, the drug interacts with certain benzo-diazepines
(e.g., triazolam, Halcion/Upjohn). (Frewer LJ, Lader M. Int Clin Psychopharmacol.
1993; 8:13-20. Walsh AE et al. Biol Psychiatr. 1993; 33: 115-119.)
~~~~~~~~~~
Additionally, she was told that Serzone would not cause sexual dysfunction, so if
it won't prevent orgasm, perhaps it also won't inhibit let down? Given some of
the recent discussions about SSRI's and let down, I thought this might be
interesting to the list.
Debbie McCallister
Louisville, KY
Non-professional lurker & breastfeeding busybody
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Date: Thu, 16 Mar 2000 14:53:29 -0500
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From: Susan Keith-Hergert <[log in to unmask]>
Subject: Re: 6 hour pump reference
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The New ILCA standards for evidence based practice state "If effective
breastfeeding, as demonstrated by milk transfer, is not observed within the
first 24 hours...............initiate pumping with a hospital grade pump."
Up until that time, of course, the mom and babe are to be rooming in, doing skin
to skin, learning cues etc. But, I read this to be supportive of the earlier
suggestions that it is not necessary to get such a mom pumping at six hours.
Susan
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Date: Thu, 16 Mar 2000 16:08:08 -0400
Reply-To: Lactation Information and Discussion
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From: Marilyn Norton <[log in to unmask]>
Subject: pumping early and often?
Comments: To: [log in to unmask]
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Jean wrote:
> At the risk of sounding well, simple-minded, I submit the following
reminder.
> If we do nothing at all about pumping and the mother doesn't put the baby
to
> the breast at all, colostrum and milk will still "come in
> So, I don't think we should get too hung up on numbers or arbitrary time
> frames.
What about engorgement? I understood that, in simple terms, if your breasts
aren't stimulated early and often, then although you may become engorged,
the milk supply down the road may be impaired.
> Where I work, we've recently revised our policies for "normal" newborns
and
> breastfeeding expectations. Our expected normal for the baby within the
> first 24 hours of life is: one latch/suck/breastfeeding. More is fine,
> obviously. We found that nurses were spending 20, 20 or 40 minutes w/ a
mom
> and baby "trying" to get the poor baby to latch. This led to frustration,
> babies' being quite turned off about feeding, increased maternal anxiety
> (what was the problem really--I think it was our expectations of what the
> baby "should" do).
This can work the other way as well, I think that any one who has educated
themselves even a little prior to giving birth would also be very frustrated
if her baby wasn't nursing 8x in 24 hours like all the books suggest. I
suppose each case is different. We try to encourage lots of skin to skin,
but also monitor the situation so that we aren't frustrating the baby ,
usually when baby is showing cues, we will try about 15 minutes, if no
luck, then have mom pump. This has worked out well because as you all know
10 minutes can quickly turn to 60 minutes and the baby stilll hasn't been
fed.
>I don't believe we've seen any significant
> differences in milk production regardless of when the mom starts pumping.
> Really, based on physiology of lactogenesis, we have two weeks for milk
> production to proceed, so what's the hurry??
Are there studies to prove this? I would really like to know, maybe we are
indeed putting too much emphasis on the early and often idea.
Marilyn
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Date: Thu, 16 Mar 2000 15:05:41 -0500
Reply-To: Lactation Information and Discussion
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From: Susan Keith-Hergert <[log in to unmask]>
Subject: Re: 6 hr pumping rule....
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Yes, Bonnie, I see your reasoning here but....it is not always appropriate and
necessary to apply special situation care to normal moms and babies. I think
that has been well demonstrated in obstetrics.
As with any intervention....benefits of early pumping must be weighed against
risks. If a mom is focusing on pumping is she relaxing, skin to skin with her
baby? Is she learning to respect her baby's cues? Is she developing trust in her
innate ability to care for an infant, and produce milk for him? If you are
concerned about the baby getting something.....why not have her manually express
some colostrum into her baby's mouth every few hours until he catches on? ( I
am talking about the first 24 hours here.)
In the absence of evidence that early pumping is clearly necessary...I don't
hink we should set policy on the assumption that "more intervention is better."
In general, that kind of thinking has cost moms and babies an awful lot.
Just MHO (with a little help from ILCA),
Susan Keith-Hergert RN, MS, CPN, IBCLC
Bonnie <[log in to unmask]> on 03/15/2000 10:48:22 PM
Please respond to Lactation Information and Discussion
<[log in to unmask]>
To: [log in to unmask]
cc: (bcc: Susan J Keith-Hergert/MGCR/CHP)
Subject: 6 hr pumping rule....
I know the issue was clarified ie: re a baby in NICU but just a thought here...
Is milk not made on a supply & demand basis? Therefore, if you have a baby
not br.fdng for what ever the reason, is it not safe to assume, that by
initiating pumping, and pumping frequently, the milk will be there for when
baby does succussfully latch and feed?
Bonnie RN,IBCLC
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Date: Thu, 16 Mar 2000 15:12:44 -0500
Reply-To: Lactation Information and Discussion
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From: Barb <[log in to unmask]>
Subject: Diarrhea and menses
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I have a mom who is breastfeeding an 18 month old. Yesterday, she got
her first period since his birth. Her child has had loose, copious,
smelly stools about 3 times a day for the last two days. He has no
fever, no vomitting, and seems well. He has had a very good appetite,
eating more than usual the last few days. He still breastfeeds quite a
lot. Could his diarrhea be related to her menstrual period, or is it
just coincidence?
Barb Berges BS, RN, IBCLC
Rochester, New York
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Date: Thu, 16 Mar 2000 15:20:54 -1000
Reply-To: Lactation Information and Discussion
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From: Pam Easterday <[log in to unmask]>
Subject: S. aureus and soap
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Fascinating that hand washing increased staph in your experiment. Was that
>bars of soap used or liquid from squirt bottle?
Most, if not all, were squirt bottles.
Thanks for the answer on milk killing this bacteria.
Pam Easterday
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Date: Thu, 16 Mar 2000 16:04:14 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Re: Nursing Strikes
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Does anyone have any good references on nursing strikes? Can't seem to find
much.
Nancy
Nancy E. Wight MD, FAAP, IBCLC
Neonatologist
Medical Director, Lactation Services
San Diego, CA, USA
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Date: Thu, 16 Mar 2000 16:18:44 EST
Reply-To: Lactation Information and Discussion
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Subject: thoughts on "6-hour rule"
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Dear Friends:
If I want the mother to imprint on the pump, as with a premature or sick
baby separated from her at birth, I would encourage pumping ASAP.
Otherwise, keep 'em close, skin-to-skin and give them some privacy. How
can an intimate relationship be established with peepers coming in every hour
or two?
Warmly,
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: Thu, 16 Mar 2000 15:26:59 -0600
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From: gima <[log in to unmask]>
Subject: What is this little guy doing?
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I have a client whose baby has been doing something "funny" for the past week.
He is 5 weeks old. For the first 4 weeks all was well. As of last week, he
latches on, begins to feed, and 5-6 minutes into the feeding (almost
exactly the same time each feeding) he changes his suck and just stops
feeding well--sort of like "non nutritive" sucking--then he gets frustrated
seemingly because no milk is coming. He jerks off, and after a bit will
latch on again and feed fine the rest of the feeding.
He does this only on the first breast of the feeding--either side. When he
goes to the second side, he doesn't do this "dance." He never does it on
the second side, even if this side is fuller.
He is a thriving, contented baby, except for this 5-6 minute-first-side thing.
I haven't seen the baby because they live about 60 miles away. I don't
know if a long distance visit is needed or not. It would cost a lot with
mileage.
Do any of you have any suggestions or questions that I could ask that might
enlighten us?
Pat Gima, IBCLC
Milwaukee, Wisconsin
Mailto:[log in to unmask]
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Date: Thu, 16 Mar 2000 13:59:48 -0800
Reply-To: Lactation Information and Discussion
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: mittens inhibiting MER
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Dianne: YES! I've witnessed this but not with winter mittens. It seems as
though the babies who have the soft cotton flip over kind to stop themselves
from scratching can do this as well. I have a theory on this...if you've
ever witnessed kittens, lambs or piglets nursing they "knead" the
breast/teat. Well, in fact, the older ones are down right rough and really
poke and prod the breast to stimulate MER. I wonder if the lack of those
little groping hands (which can definitely get in the way and make moms wish
they were an octopus mom) help MER via skin to skin contact and alternating
pressure.
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: Thu, 16 Mar 2000 18:16:18 -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: Re: What is this little guy doing?
Comments: cc: [log in to unmask]
I just worked with a mom recently whose baby girl did almost the same thing.
I had mom try breast compression at about 4 minutes of nursing and baby
continued to nurse well when the flow was increased. With the mom I worked
with , the baby only did this on one side, the one that mom felt had the
lower supply.
Might have mom try it.....
Read Jacks article to learn more :
http://users.erols.com/cindyrn/15.htm
Let us know what happens!
Cindy
Cindy Curtis,RN,IBCLC
mailto:[log in to unmask]
http://www.erols.com/cindyrn
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Date: Thu, 16 Mar 2000 19:13:29 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Valerie W. McClain, IBCLC" <[log in to unmask]>
Subject: Re: HIV letter
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I agree with carol's post and particularly her praise of Magda et al's e-mail
letter to the BMJ. But I do have a problem with one of carol's comments.
That comment was in regard to mothers in developed countries such as the US
"with HIV don't especially want to breastfeed anyway." Is it that they don't
want to breastfeed? Or is it that women are being threatened with loss of
custody of their infants if they make such a choice? The Tyson case is a
good example of a mother diagnosed hiv-positive who wanted to breastfeed and
was forced by the State to formula-feed. Currently, in the US, mothers who
are diagnosed as hiv-positive(there are 60 known conditions that can make one
test positive including pregnancy!)are told not to breastfeed. Let us not
mistake force for choice. Valerie W. McClain, IBCLC
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Date: Fri, 17 Mar 2000 09:35:45 +0800
Reply-To: Lactation Information and Discussion
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From: Joy Anderson <[log in to unmask]>
Subject: Fwd: RE: Maternal osteogenesis imperfecta
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Further to my post on the above, Nancy Ferland wrote back to me the
following. She has given me permission to share it with you all.
Thought it might help someone else.
>I had a mother who had brittle bone disease and nursed 3 babies!
>the first two were only nursed about 6 weeks. Her bone density did
>return to their pre-preg. levels within 4 weeks of discontinuing BF.
>With her third child, mom wanted to nurse longer than 6 weeks and
>doc said only 3 months but mother must have density test every 2
>weeks. She did and there was no significant change. When baby
>reached 3 months, she supplemented with ABM up to 20 oz/day or
>basically every other feed. Baby nursed about 4 times a day and
>once at night. At 6 months bone mass density was the same as 3
>month level. Doc was satisfied that mom continue this pattern for
>next 6 months with testing every month. Of course, baby took less
>and less breastmilk with solids and supp. from a cup. Baby was
>totally weaned at 13 months and mother was thrilled that by 18
>months her bone density was actually greater than her pre-pregnancy
>level. It just goes to show you that there is always a compromise
>that can be made. Hope this helps!
>Nancy Ferland, IBCLC
******************************************************************
Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Nursing Mothers' Association of Australia Breastfeeding Counsellor
Perth, Western Australia. mailto:[log in to unmask]
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Date: Fri, 17 Mar 2000 11:46:26 +1000
Reply-To: Lactation Information and Discussion
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From: Denise Fisher <[log in to unmask]>
Subject: expressing vs pumping
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Susan writes:
>As with any intervention....benefits of early pumping must be weighed against
risks. If a mom is focusing on pumping is she relaxing, skin to skin with her
baby? Is she learning to respect her baby's cues? Is she developing trust
in her
innate ability to care for an infant, and produce milk for him? If you are
concerned about the baby getting something.....why not have her manually
express
some colostrum into her baby's mouth every few hours until he catches on? ( I
am talking about the first 24 hours here.)>
Absolutely. I guess this is an international terminology issue - I usually
use the term 'express' to mean either hand expression or using any kind of
mechanical pump. Which I then extrapolated back again to presume when you
(as in all other posters) were saying 'no removal by any means' (other than
baby) of milk from the breasts for 12 to 24 hours. My apologies - gosh and
English is my first (and only) language :-)
- I feel sorry for our ESL (English as a second language) lactnuts.
As far as I know, and everywhere I have worked in Australia (3 of our 8
States and territories), mechanical pumping, either with a hand pump or an
electric pump NEVER starts before lactogenesis II. Would other Aussies like
to confirm or deny this?
Marilyn writes:
>I tend to find that with
primigravidas, or first time breastfeeders tend to really massage, squeeze
etc.quite strongly in order to get milk, thus perhaps causing themselves
some temporary soreness from hand expressing.>
Ooo Marilyn I can feel myself cringeing as I read your words. This is only
an education issue. All women need to be taught, by well educated staff
(or someone), how to hand express properly. It shouldn't be presumed that
they will know what to do - it's a learned skill.
Chele Marmet has an excellent handout that teaches both mothers and staff
the correct technique.
http://www.parentsplace.com/readroom/medela/manual.html
And, at the expense of promoting *another* NMAA video, those of you who can
obtain it the video "Hand Expressing and Cup Feeding" is EXCELLENT -
brilliant even! This was produced by Wendy Nicholson, IBCLC author of
Midwives, Mothers and Breastfeeding. (not Sue Cox, author of Breastfeeding:
I Can Do That, and the fabulous Latching video this time :-) ) - no, no
commissions to me.
http://www.nmaa.net.au
(BTW - there are some NMAA videos I won't promote ;-) )
Marilyn goes on to say:
>A pump has a more regular
action and it does help to tell the mom not to expect very much initially,
but when baby 'wakes' or finally does go to the breast, her supply will meet
his needs.>
When *nothing* is coming out in the pump for 6 - 7 sessions and her baby
must therefore be receiving ABM I think it must be very difficult to
reassure her - and put big doubts into her mind even when he does go to the
breast, after say 3 or 4 pumping sessions, when she has *never* seen
anything produced by something as *strong* as an electric breast pump.
Please consider hand expressing. It really is a minimal and gentle
intervention which does produce the mother's own breastmilk which can then
be given to her baby.
Denise
fair dinkum Aussie
****************************************************
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: Thu, 16 Mar 2000 21:22:15 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: "Michelle I. Scott" <[log in to unmask]>
Subject: mom with low progesterone levels
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Hi LactNetters, just got a message from a friend who has a mom with low =
prenatal progesterone levels, and now at 5 d does not seem to have milk? =
What to do? Anybody else had this? M.Scott, RD,IBCLC in NH
=20
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Date: Thu, 16 Mar 2000 18:59:33 -0800
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<[log in to unmask]>
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: kneading, oral fixation, weaning, kittens
Comments: To: Diane Wiessinger <[log in to unmask]>
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Not only have I witnessed the kitten phenom (lifelong kneaders), but I
actually had one cat who used to nurse on my earlobes! She lived till a
ripe old age of 26--even with her oral fixation. (I still think the
predominance of adult oral fixations in western culture is related to not
getting enough sucking time in as a baby). My mom used to raise persian
kittens and never let them go until 12-14 weeks because they needed the
extra nursing time, which is considered quite old in breeding terms. Oddly
enough this is the woman who didn't bf me because her breasts were my
"father's property." Go figure!
- "> That's what these were. Or some of them. Sometimes he was in
pull-offs,
> sometimes in sleeve ones. But always covered.
>
> Speaking of kneading, do you remember the kitten thread on lactnet a couple
> years ago? Apparently kittens who are weaned before their time tend to be
> kneaders for life; self-weaned kittens lose the urge. Interesting.
>
> Diane"
>
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Date: Thu, 16 Mar 2000 19:06:30 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: epinephrine & pump and dump
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I thought you'd all appreciate this one...I just came from my dentist's
office and was told to pump and not to nurse for 24 hours because I had
Novcaine with epinephrine. His theory is that the epi would be hazardous to
my nursing 22 month old. I then asked him what the T1/2 and protein
binding of epi is, but he didn't know. Of course I promptly came home and
looked it up.
This IS the same dentist that my friend sees (the one who was told to wean
because of her gums).
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: Thu, 16 Mar 2000 19:08:44 -0800
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<[log in to unmask]>
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: premies and 6 hour rule
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Pat: Your 12 hr rule with premies sound reasonable to me. :)
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: Thu, 16 Mar 2000 22:14:27 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Kathy and Paul Koch <[log in to unmask]>
Subject: Re: kneading, oral fixation, weaning, kittens
In-Reply-To: <[log in to unmask]>
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> Not only have I witnessed the kitten phenom (lifelong kneaders), but I
> actually had one cat who used to nurse on my earlobes! She lived till a
> ripe old age of 26--even with her oral fixation.
I have a 13 year old cat that does this. Actually, I don't let him because
I hate claws and cat slobber on my neck. My husband will let him
occasionally but I encouraged his early weaning from my ears. I do think he
was taken from his mother too soon.
Kathy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Kathy Koch, BSEd, IBCLC
Great Mills, MD
mailto:[log in to unmask]
http://www.bftopics.org
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Date: Thu, 16 Mar 2000 22:33:42 EST
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From: Carol Brussel <[log in to unmask]>
Subject: hiv letter
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valerie is right, i just didn't take the time to talk about my feelings about
that further. i think a lot of mothers "don't want to breastfeed" but its not
because they don't want to, they don't even believe they might be able to do
so. they can't make a choice because the choice has been made so far back in
their lives that it isn't a choice any more.
and valerie is quite right in describing this as force. and aren't mothers
forced every day? lots of time "not breastfeeding" is forced on even the ones
that want to. its hardly a surprise that the mothers who have special
situations might already have figured out, from how they are treated during
pregnancy, that they will never be able to breastfeed. the tyson case is a
frightening example of what happens to the occasional mother who does still
think she has a choice. of course she didn't have a choice; she got punished
for her audacity, being already "guilty" of HIV.
and i don't think they are merely threatened with loss of custody. they are
also blatantly threatened with "you will be the murderer of your baby if you
persevere with this insane and selfish idea." just as many mothers are
threatened with the same thing for other situations - supplementation,
pacifiers, etc.
carol brussel IBCLC
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Date: Thu, 16 Mar 2000 20:51:48 PST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Traci Mills <[log in to unmask]>
Subject: staph infection/Journal Club #2
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OK, I know I'm showing my ignorance here, (I'm not a nurse), but if mom has
staph in the breast, would it be transferred to the baby, like yeast? Do mom
and baby both have to be treated?
Traci in Texas
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Date: Fri, 17 Mar 2000 12:46:23 +0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Joy Anderson <[log in to unmask]>
Subject: NMAA URL again!
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>And, at the expense of promoting *another* NMAA video, those of you who can
>obtain it the video "Hand Expressing and Cup Feeding" is EXCELLENT -
>brilliant even! This was produced by Wendy Nicholson, IBCLC author of
>Midwives, Mothers and Breastfeeding. (not Sue Cox, author of Breastfeeding:
>I Can Do That, and the fabulous Latching video this time :-) ) - no, no
>commissions to me.
>http://www.nmaa.net.au
You've done it again, Denise!!!! The URL is 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: Fri, 17 Mar 2000 13:55:06 +0930
Reply-To: Lactation Information and Discussion
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From: Querida David <[log in to unmask]>
Subject: Low Progesterone
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I sent this privately before, but there have been several requests lately
and this article may help.
Querida David IBCLC
Last December's JHL has a case
study describing a woman diagnosed with insufficient glandular tissue with
her first baby, who could not produce more than a very small amount of milk
despite being prescribed metoclopromide (Maxolon).
This mother, after treatment with natural progesterone during a subsequent
pregnancy, was able to fully breastfeed her second child.
It is a very interesting case study. This mother had other fertility related
issues, and miscarriages related to what was diagnosed as a luteal phase
defect.
The reference, for those who have access to JHL is Volume 15, number 4,
December 1999
page 339. Case Report
Patient with insufficient glandular tissue experiences milk supply increase
attributed to progesterone treatment for luteal phase defect.
I hope this reference helps the mother that you are working with.
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Date: Thu, 16 Mar 2000 22:06:56 -0800
Reply-To: Lactation Information and Discussion
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From: Katherine Catone <[log in to unmask]>
Organization: home
Subject: Nursing strikes
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The Breastfeeding Answer Book has a couple pages on nursing strikes and
a long list of reasons to go through.
Katherine Catone, LLLL, IBCLC
http://www.pe.net/~skcat1/index.html
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Date: Fri, 17 Mar 2000 01:13:50 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Re: Nursing Mothers of Aust web page
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I cannot seem to get this web page. Keeps saying "This page cannot be
displayed". Is the URL correct?
Nancy
Nancy E. Wight MD, FAAP, IBCLC
Neonatologist
Medical Director, Lactation Services
San Diego, CA, USA
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Date: Fri, 17 Mar 2000 16:09:21 +0930
Reply-To: Lactation Information and Discussion
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From: Robyn Aulmann <[log in to unmask]>
Subject: HIV
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Dear Lactnetters,
I have found that the overall opinion of medical staff decides in Hep C/ =
HIV Cases . A big No to BFing. The comments from many MD's, RMO, and =
Registrars in our Hospital clinic dampens all the BF enthusiasm. I have =
been instrumental in changing the policy here for Hep C to a yes for =
Breast feeding but it remains a big NO for HIV,Still.
Most Midwives here still "fear" the client with both. Even Hep B 'with =
some' is treated as a 'No for BF'- I've been through that one and had =
policy changes initiated. Those people have no rational fopr it either.
Keep up the good work,
Robyn Aulmann,
RM FACM,
Darwin, N.T, Australia
Date: Thu, 16 Mar 2000 22:33:42 EST
From: Carol Brussel <[log in to unmask]>
Subject: hiv letter
valerie is right, i just didn't take the time to talk about my feelings =
about
that further. i think a lot of mothers "don't want to breastfeed" but =
its not
because they don't want to, they don't even believe they might be able =
to do
so. they can't make a choice because the choice has been made so far =
back in
their lives that it isn't a choice any more.
and valerie is quite right in describing this as force. and aren't =
mothers
forced every day? lots of time "not breastfeeding" is forced on even the =
ones
that want to. its hardly a surprise that the mothers who have special
situations might already have figured out, from how they are treated =
during
pregnancy, that they will never be able to breastfeed. the tyson case is =
a
frightening example of what happens to the occasional mother who does =
still
think she has a choice. of course she didn't have a choice; she got =
punished
for her audacity, being already "guilty" of HIV.
and i don't think they are merely threatened with loss of custody. they =
are
also blatantly threatened with "you will be the murderer of your baby if =
you
persevere with this insane and selfish idea." just as many mothers are
threatened with the same thing for other situations - supplementation,
pacifiers, etc.
carol brussel IBCLC
------------------------------
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Date: Fri, 17 Mar 2000 03:20:44 EST
Reply-To: Lactation Information and Discussion
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From: Gloria Buoncristiano-Thai <[log in to unmask]>
Subject: my 5 minutes of fame
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Aloha,
Just wanted to share with everyone that I will be talking about breastfeeding
and Baby-Friendly Hospitals on a local morning show March 17th. Should only
amount to a couple minutes at the end of the program. Not exactly 15 minutes
of fame!
Wish me luck---not to be so nervous that I totally draw a blank.
Aloha,
Gloria Thai
Honolulu, O'ahu, Hawai'i
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Date: Fri, 17 Mar 2000 09:51:00 +0100
Reply-To: Lactation Information and Discussion
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From: "A. Bon" <[log in to unmask]>
Subject: Re: mittens
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> Last summer I went to the LLL International breastfeeding Conference in
> Orlando and heard Dr Marshall Klaus speak, "Perinatal Care in the 21st
> Century: evidence that supports changing the management for both mother
and
> infant." I took some notes and it says in my notes do not wash hands of
> baby--baby will not suckle. These were notes I had in the continuing ed
> syllabus. On page 23 of that syllabus Klaus writes, "In order not to
remove
> the taste ans smell of the mother's amniotic fluid, it is necessary to
delay
> washing the baby's hands. The baby uses the taste and smell of the
amniotic
> fluid on his hands to make a connection with a certain oily substance on
the
> nipple related to the amniotic fluid."
Very interesting!!
Please forgive me my ignorance and lack of expereince... I've never been at
a birth (except my own ones)... I've seen two video's that showed
self-attachment rigth after birth. And I noticed that both babies used
their hands for orientation. First they put their hands in their mouths ,
then they reached for the aureola, and grasped it. And suprisingly after
they grasped the nipple, they moved to the opposite breast and latched on
to that one. It looked to me, as if they used the aureola for orientation
in looking for the other one.
groet,
Annelies Bon
contactpersoon vereniging Borstvoeding Natuurlijk
breastfeeding resources: http://utopia.knoware.nl/users/abon/bfbronnen.htm
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Date: Fri, 17 Mar 2000 09:57:37 +0100
Reply-To: Lactation Information and Discussion
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From: Elien Rouw <[log in to unmask]>
Subject: Re: LACTNET Digest - 2 Mar 2000 - Special issue (#2000-267)
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Although I am reading Lactnet for a long time, I didn't react until now,
because it is not so easy reacting in englisch. But now I want to jump on
the discussion. So I want to introduce myself. My name is Elien Rouw. I am a
medical doctor, working in mother and child health care. I am Dutch, but I
live in Germany (near the Black Forrest). Since almost 20 years I am
involved in breastfeeding support, first for the Dutch Organisation
Borstvoeding Natuurlijk, and now for the German AFS (Arbeitsgemeinschaft
freier Stillgruppen). I have a small private practice for mother/child
health care and I am teaching medical health workers in hospitals on
breastfeeding (for instance hospitals, who want to become baby-friendly).
The advantage of moving from one country to another is, that you can see how
different cultural behaviour influences our practices. I have observed, that
the parents here in South-Germany actually are much more afraid, their
children are catching a cold, as Dutch parents are. They themselves walk
around in t-shirts, but their children wear woolen mittens and woolen hats
(even in their homes) and are in clothes which can be used in a winterstorm,
so they won't be cold. But in this way they cannot regulate their
temperature. Most of the time this is not a problem, but I also see some
children, wo are definitely too warm. When they are too warm, they don't
come to breastfeed regularly, they sleep at the breast, they don't latch on
properly and they loose the nipple constantly. In this way breastfeeding
problems can arise and the children don't gain weight. I even had children
with fever, only because they had far too much clothes! When I talk to the
parents in the first visit, I mostly tell them about the clothing of their
child: not too cold of course, but certainly not too warm! (Too much heat
can also contribute to SIDS!!)
Elien Rouw, MD, Bühl, Germany
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Date: Fri, 17 Mar 2000 04:26:54 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Valerie W. McClain, IBCLC" <[log in to unmask]>
Subject: Re: HIV letter
Comments: cc: [log in to unmask]
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Carol, I have to disagree with you again because there is a difference
between women who are diagnosed hiv-positive and forced to use formula and
women who are not so-diagnosed but "feel" forced to use formula. One is
about the power of the State to control a mother's behavior with her infant.
This behavior, breastfeeding, is as powerful, innate as our sexual behavior.
And yes, the Tyson case may seem to the observer that the State "occassional"
forces a mother to not breastfeed. But it only takes one case like this to
effect many women. And, I would say that if you see one case, you know that
there are more out there. A woman who is not diagnosed as hiv-positive may
"feel" forced to use formula. But she does not have the very real threat that
her infant will be taken away from her if she doe not comply with the wishes
of the State. Let us remember that the decision in 1985 by the CDC to
discourage breastfeeding was not based on alot of scientific proof. It was
based on 4 cases, letters not studies written to the Lancet. Valerie W.
McClain, IBCLC
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Date: Fri, 17 Mar 2000 14:02:47 +0800
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<[log in to unmask]>
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From: Kirsten Blacker <[log in to unmask]>
Subject: Re: what is this little guy doing?
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Bear with me, this is my first post! Is it possible that this mum is having
a let down after 3-4 minutes, the baby is getting a 'gush' and then getting
frustrated when this stops? It would help if mum was able to distinguish
when she lets down, to know if the timing corresponded.
Kirsten Blacker
RN RM
-
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Date: Fri, 17 Mar 2000 09:30:39 +0000
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<[log in to unmask]>
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From: heather <[log in to unmask]>
Subject: Re: expressing vs pumping
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Denise's 'defence' of hand expressing is something I would go along with -
it's common practice in the UK to hand express before using any form of
pump, for term babies as well as pre-term babies, and as hand expressing
usually gets something, however small, that can be collected and given to
the baby (unlike the pump) it makes a lot of sense for mothers to do this
in the early days.
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
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Date: Fri, 17 Mar 2000 20:50:38 +1030
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<[log in to unmask]>
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From: Mrs BN Carney <[log in to unmask]>
Organization: Dragonheim
Subject: Re: expressing vs pumping
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heather wrote:
>
> Denise's 'defence' of hand expressing is something I would go along with -
> it's common practice in the UK to hand express before using any form of
> pump, for term babies as well as pre-term babies, and as hand expressing
> usually gets something, however small, that can be collected and given to
> the baby (unlike the pump) it makes a lot of sense for mothers to do this
> in the early days.
>
> Heather Welford Neil
> NCT bfc Newcastle upon Tyne UK
In my own experience in a hospital in Adelaide SA, I was asked to hand
express some colostrom for my baby when he had early nursing problems,
the midwife spent a lot of time with me being offering encouragement
with every drop that came out. Never was any kind of mechanical device
offered or mentioned at that stage. BTW the midwife was very impressed
with the amount of colostrom I managed to express, 20ml :) I imagine a
good deal of that might have been lost in pump tubing etc.
Gitte
--
BN Carney @>-->-
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"If you want your child to be brilliant, tell them fairy tales.
If you want your child to be very brilliant, tell them even
more fairy tales" - Albert Einstein
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Date: Fri, 17 Mar 2000 06:11:08 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: Re: nursing strikes
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Nancy:
there was excellent article in JHL some years ago by Katie Winchell.
Patricia
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Date: Fri, 17 Mar 2000 12:14:58 +0100
Reply-To: Lactation Information and Discussion
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From: Rietveld <[log in to unmask]>
Subject: Re: expressing vs pumping
In-Reply-To: <l03130301b4f7ab08ae67@[195.147.235.115]>
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Hi Heather and Denise,
To the best of my knowledge, hand expressing before using any form of pump,
isn't common practice in The Netherlands (geographically seen 'next' to the
UK). My experience is that hand expressing is used too little (by moms) and
when it's used I see it often done like only compressing the nipple instead
of reaching the sinusses. This shows the cultural differences once more.
It's nice to see the different approaches and to learn the different ways
of naming things (Denise, I didn't know you meant this by 'expressing' :-o).
Ok, yes, I'll confess, I'm totally and completely addicted to Lactnet.
Thanks for being there.......
Renate Rietveld, IBCLC
Rijswijk, The Netherlands
At 09:30 17-3-00 +0000, Heather from the UK wrote:
>Denise's 'defence' of hand expressing is something I would go along with -
>it's common practice in the UK to hand express before using any form of
>pump, for term babies as well as pre-term babies, and as hand expressing
>usually gets something, however small, that can be collected and given to
>the baby (unlike the pump) it makes a lot of sense for mothers to do this
>in the early days.
--------------------------------------------------------------
Renate Rietveld, IBCLC
E-mail : [log in to unmask]
Homepage: http://www.casema.net/~rietveld/index.htm
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Date: Thu, 16 Mar 2000 21:20:29 -0500
Reply-To: Lactation Information and Discussion
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From: Patrica Young <[log in to unmask]>
Subject: Re: breast surgery and a request
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Dear Pat, I followed one mom through three babies BFing. She was burned as
a child and the nipple was occluded on one side. She filled, engorged and
involuted each time, the process seemed to take less time each baby.
Sincerely, Pat in SNJ
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Date: Fri, 17 Mar 2000 06:33:42 -0500
Reply-To: Lactation Information and Discussion
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From: Patrica Young <[log in to unmask]>
Subject: Re: LACTNET Digest - 2 Mar 2000 - Special issue (#2000-267)
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Dear Elien, I think too much heat (besides SIDS danger) tends to make kids
have more colds, runny noses etc. I'm always asking what they have the
house temperature set on. New parents with new babies frequently have the
temperature set on 75 F, even 80 F! (23 - 27 C) I'm always preaching that
babies only need one more layer than parents have on. They look at me in
amazement. Or one parent will say to the other "I told you so!"
Sincerely, Pat in SNJ
P.S. My German exchange student says Hi!
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Date: Fri, 17 Mar 2000 08:01:51 -0400
Reply-To: Lactation Information and Discussion
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From: Marilyn Norton <[log in to unmask]>
Subject: Re hand expression
Comments: cc: [log in to unmask]
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Denise,
I didn't mean to say that hand expression shouldn't be an option.
I really do believe that and hand expression is best, but, believe me, we
have a hard enough time getting our staff educated about breastfeeding the
healthy, full term, unmedicated infant. They would have a field day with
hand expression. We only have a LC available 4 hours/day, so that leaves a
lot of room for the other staff to do their thing.
Also, our clientelle are not often the sort to 'want' to room-in, kangaroo
etc , (but we keep trying). If I am able to get to the mom soon after
delivery, that's great, but she may deliver just atfter I leave, then the
evening and night staff ( who like numbers, amounts, times etc) will be
doing the initial assessment & teaching. We are really trying to educate but
often times, it seems as though they nod in agreement when the inservice is
presented, then go ahead and do what they think is best for mom and baby.
How can we change this. We have posted the handout on hand expression and
really none of the nurses want to consider this- some days I really wish
that the pumps would break down and then see what would happen :)
thanks for you comments and video suggestion, I will certainly look into it.
Marilyn
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Date: Fri, 17 Mar 2000 07:39:49 -0500
Reply-To: Lactation Information and Discussion
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From: Kerri Zandberg <[log in to unmask]>
Subject: Polycystic Ovaries and oversupply
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Hello,
I am presently taking Jan Riordan's internet breastfeeding course and
would love to hear from anyone re some thoughts of mine for my paper -
in which I'm looking at Polycystic Ovarian Syndrome and a case study of
a woman with tremendous oversupply.
I found some good information in the Archives on this and have
communicated with Lisa Marasco from the List who has been a wonderful
source of information.
My question: is there a maximum effect of prolactin on milk supply?
I'm thinking of the prolactin receptor theory, and maybe maximum number
of receptors? Or does higher and higher prolactin cause more and more
milk to be produced?
Also hyperinsulinemia is common with PCO. Ruth Lawrence talks about how
the breast is a target organ for insulin, with insulin receptors in the
mammary gland acini - How would hyperinsulinemia come into play here?
What effect is excess insulin and prolactin going to have here?
Would love any thoughts anyone might have,.
Kerri Zandberg, R.N., B.ScN., Chatham, Ontario, Canada
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Date: Fri, 17 Mar 2000 08:21:00 EST
Reply-To: Lactation Information and Discussion
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From: Roni Chastain <[log in to unmask]>
Subject: Re: Things to contemplate about advertising
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I get lots of jokes from friends. This one came in this morning. I just
thought I would share a few, especially since the first one was about our
favorite subject.
Roni Chastain, RN, LCCE, FACCE
Long Island, New York
Things to contemplate about advertising
>1. The Dairy Association's huge success with the campaign
>"Got Milk?" prompted them to expand advertising to Mexico. It
>was soon brought to their attention the Spanish translation
>read "Are you lactating?"
>
>2. Coors put its slogan, "Turn It Loose," into Spanish, where
>it was read as "Suffer From Diarrhea."
>
>3. Scandinavian vacuum manufacturer Electrolux used the
>following in an American campaign: "Nothing sucks like an
>Electrolux."
>>
>5. When Gerber started selling baby food in Africa, they used
>the same packaging as in the US, with the smiling baby on the
>label. Later they learned that in Africa, companies routinely
>put pictures on the labels of what's inside, since many people
>can't read.
>
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Date: Fri, 17 Mar 2000 09:05:00 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: S. aureus, soap and hand washing
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In a message dated 3/16/2000 10:20:41 PM Eastern Standard Time,
[log in to unmask] writes:
>
> Fascinating that hand washing increased staph in your experiment. Was that
> >bars of soap used or liquid from squirt bottle?
>
We did an experiment in freshman microbiology in college. We were required
to have a series of sterile culture plates, touch the first with our UNwashed
hand, then wash our hands, touch the next plate, wash again, touch next
plate, etc. The instructor did not tell us what to expect and we were amazed
to see MORE colonies grow in the plates after we washed our hands and more in
each successive plate after each hand washing. Then we were challenged to
explain the results.
The hand washing experiment demonstrates there are many germs on and in the
skin, usually "normal flora" that actually protect us. It does not mean that
washing is bad or unnecessary. Bars of soap can harbor many bacteria also,
that is why they are not used in public places. The next step is to identify
the germs. If a pathogen, a disease causing germ, is prevalent, then further
investigation should be done as this person may be infected or a carrier (a
Typhoid Mary so to speak) and need treatment. Just having more germs show
up after hand washing is alarming at first until you understand what is going
on. Having pathogens that can cause disease is what determines if
treatment is needed. AND certain pathogens are expected to be found in many
areas of the body.
I always remember my college roomate, who was in dental hygiene, taught me
there are 28 deadly pathogens found in the human mouth of most healthy
individuals. If our immune system is good, the pathogens stay in the mouth
and cause no problems. The human mouth is a very dirty place, much worse
than an animal's mouth. (That is the reason a human bite is more dangerous
than an animal bite and more likely to become infected and even cause life
threatening heart infection) (Vet's wife speaking here again)
Jane Bradshaw RN, BSN, IBCLC
Lynchburg, VA
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Date: Fri, 17 Mar 2000 15:40:47 +0100
Reply-To: Lactation Information and Discussion
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Fw: BV-PROFS: baby care G speen
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This is a question I ask for a Dutch collegue (RN/LC) who is not (as for now) a
lactnetter:
--- At our postnatal ward they started using a baby-care G nipple.
--- This is a artificial nipple with the pores at the basis of it and therefore
--- has an empty part that will be in the mouth like a (breast-)nipple. I did
not yet
--- see any sign of increasing success at the breast in babies
--- that used it and would like to hear your opinions about it.
Anyone w'ho would like to her personally could do so at:
[log in to unmask], but I think commentaries to the list will be
interesting for more lactnetters.
TIA,
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
http://www.users.skynet.be/eurolac
[log in to unmask]
Original message:
> > > > Bij ons op de zuigelingenafdeling is men
> > begonnen met
> > > > bijvoeden via de baby-care G speen
> > > > Een speen die de uitgang aan de basis van de
> > speen
> > > > heeft zitten en dus een loos stuk speen wat als
> > > > "tepel" in de mond van de baby ligt.
> > > > Tot nu toe merk ik niet dat baby's dan beter aan
> > de
> > > > borst gaan en ik zou graag jullie mening
> > hierover
> > > > hebben.
> > > > Groeten Astrid.
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Date: Fri, 17 Mar 2000 16:00:32 +0100
Reply-To: Lactation Information and Discussion
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From: Rietveld <[log in to unmask]>
Subject: Re: S. aureus, soap and hand washing
In-Reply-To: <[log in to unmask]>
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Jane,
Thanks so much for sharing/explaining. This is fascinating !
Renate
>> Fascinating that hand washing increased staph in your experiment. Was
that
>> >bars of soap used or liquid from squirt bottle?
>>
>We did an experiment in freshman microbiology in college. We were required
>to have a series of sterile culture plates, touch the first with our UNwashed
>hand, then wash our hands, touch the next plate, wash again, touch next
>plate, etc. The instructor did not tell us what to expect and we were amazed
>to see MORE colonies grow in the plates after we washed our hands and more in
>each successive plate after each hand washing. Then we were challenged to
>explain the results.
--------------------------------------------------------------
Renate Rietveld, IBCLC
E-mail : [log in to unmask]
Homepage: http://www.casema.net/~rietveld/index.htm
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Date: Fri, 17 Mar 2000 10:12:54 EST
Reply-To: Lactation Information and Discussion
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From: Carol Brussel <[log in to unmask]>
Subject: HIV letter
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valerie, i still think we are talking about the same thing - and women who
are not HIV postiive have the same threat hanging over them. your child is
"still" nursing? you can lose custody. your child is sleeping in your bed to
nurse? you can lose custody. same story, there are cases like the tyson case
that involve other situations. and yes, one case can certainly have a ripple
effect. i think there must even now be women hearing "you can't nurse your
baby (HIV positive mother), it's ILLEGAL."
but whether the threat of force was made implicitly or explicitly, it is
equally bad. it is not "worse" for an HIV postiive mother to be forced by law
to not breastfeed than it is for a woman to be "discouraged" by medical
misinformation to not breastfeed. circumstances do not make one example worse
than another, and magda's point that allowing HIV positive women to be
treated in this way in a formal setting (medical studies, cases of law) will
cause things to be worse for all women - its a point well taken.
carol brussel IBCLC
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Date: Fri, 17 Mar 2000 09:15:43 -0600
Reply-To: Lactation Information and Discussion
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From: Barbara Wilson-Clay <[log in to unmask]>
Organization: Austin Lactation Associates
Subject: hand-to-mouth behavior
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"Hand-to-mouth behavior is also an important consideration during assessment
of the feeding behavior. Phylogenetically, there is a functional unity
between the hand and the oral-motor apparatus in higher animal forms such as
man."
Radtka, S. Feeding Reflexes and Neutral Control, in Oral Motor Function &
Dysfunction in Children, Univ. of N. Carolina at Chapel Hill, May 25-28,
1977, pg 96.
Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com
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Date: Fri, 17 Mar 2000 10:10:51 -0500
Reply-To: Lactation Information and Discussion
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From: Clayton and Anne Nans <[log in to unmask]>
Subject: Great Resource for Breastfeeding Triplets
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Some of you have emailed me privately about resources for breastfeeding
triplets. The best resource that I have found is a book called "The Stork
Brought Three: Our Epic Journey as Parents of Triplets." by Jean P. Hall.
Jean is a mother of triplets and wrote this book based on her personal
experiences. There is an 8 1/2 page section on breastfeeding triplets and
how to make it happen from pumping soon after delivery, to getting preemies
latched on to the benefits of cleavage ;-D The book can be purchased
through:
TWINS Magazine
5350 S. Roslyn Street, Suite 400
Englewood, CO 80111-2125
(888) 55TWINS
I believe the cost is about $12
Anne Nans, RN, IBCLC
Woodbridge, VA
Mom to Caleb, Amy and Riley 12/17/98
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Date: Fri, 17 Mar 2000 10:45:16 EST
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Subject: hospital staff practice
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In a message dated 3/17/0 10:15:45 AM, Marilyn writes:
<< really trying to educate but
often times, it seems as though they nod in agreement when the inservice is
presented, then go ahead and do what they think is best for mom and baby.
How can we change this. >>
one suggestion: administration expects/requires staff to practice according
to hospital bf policy/protocol, and evaluates staff accordingly, ie; patient
chart review, customer and co-worker response, competency tesing, inservice
quiz, yearly eval criteria.
Debbie
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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Date: Fri, 17 Mar 2000 10:14:23 -0600
Reply-To: Lactation Information and Discussion
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From: gima <[log in to unmask]>
Subject: Hand washing
In-Reply-To: <[log in to unmask]>
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>The hand washing experiment demonstrates there are many germs on and in the
>skin, usually "normal flora" that actually protect us. It does not mean that
>washing is bad or unnecessary.
But it can certainly be overdone.
Jane touches on a point that is one of my present "causes." Washing hands
with antibacterial soaps, which abound these days, interferes with the
normal, healthy environment of the skin. The unhealthy balance of bacteria
that is set up is detrimental to healthy skin and robs us of protection,
allowing unhealthy pathogens on and through the skin.
I have a Ped dermatologist friend who says that if parents stopped washing
their babies with any soap, particularly abx soap, he would have to find
other work. When asked when a mother should wash her baby with soap, his
reply was, "When his knees are dirty." Good old water does just fine.
I suspect that those of you in hospitals are cringing, but remember that a
hospital is a place of unhealthy flora and the rules are quite different.
Since you spend so many hours of your lives there, it can be hard to
remember that that is not the healthy environment of "home." Many measures
that are essential for the hospital setting should be shed along with those
cute gowns before one returns home.
Even if the "home" is not as clean as it "should" be, those bacteria on the
skin at home should be left there to do their job of policing the bad guys
(perhaps *especially* if the home is not as clean as it "should" be). I
think that it would serve your patients well to caution them against trying
to wipe out as much bacteria as they can once they are home. Remind them
that the procedures of the hospital are for that environment, and that it
is not doing their families a favor to wash away the good bacteria from
their skin.
The makers of hand, dish, laundry, household cleaners are capitalizing on
the misconception that killing germs is a way to health. We are killing
off our friends and paving the way for our real enemies.
IMNSHO,
Pat Gima, IBCLC
Milwaukee, Wisconsin
Mailto:[log in to unmask]
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Date: Fri, 17 Mar 2000 12:12:21 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Alice Ernest <[log in to unmask]>
Subject: Re: Honey
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A breastfeeding mother wants to put honey in her rasberry tea. Don't think
the botulism spores can pass to baby. Am I right? Anyone see any problems
with this?
Search of archives turns up nothing. TIA
Alice Ernest IBCLC
Simpsonville, SC
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Date: Fri, 17 Mar 2000 11:17:35 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Kathy Dettwyler <[log in to unmask]>
Subject: ADVOCATING ILLEGAL PARENTING ACTIVITY
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I got this email today. I have no idea who this guy is. I'm sure his name
is not John Smith. But just so people are aware that there are madmen loose
in the world . . . I love the typo in the last sentence.
Kathy Dettwyler
>Return-Path: <[log in to unmask]>
>From: "John Smith" <[log in to unmask]>
>To: <[log in to unmask]>
>Subject: ADVOCATING ILLEGAL PARENTING ACTIVITY
>Date: Fri, 17 Mar 2000 07:18:19 -0800
>X-MSMail-Priority: Normal
>X-MimeOLE: Produced By Microsoft MimeOLE V5.00.2314.1300
>
>WARNING!
>
>It is currently a matter of awareness that certain child abuse is
widespread in U.S. culture and is being propagated by those motivated by
beliefs that must be identified and prosecuted as mental illness or blatant
pedophiliac desires in adults.
>
>With the passage of new laws in Canada and the U.S., identifying parents
and others as pedophiles for creating and possessing pictures of children,
which may be used to gratify adult sexual desires or fantasies, consciously
or subconsciously, and especially if any portions of the body are exposed to
view, it is 1000 times more offensive to the state and legal system of this
country and internationally to have parents or other care providers bathing
children beyond 24 months of age, nursing children beyond 12 months, IF AT
ALL, and diapering children beyond 18 months. It is understood by clinical
research that nursing or breastfeeding is a sexual act (exciting or
pleasurable) for the adult female, and must be seen as the exploitation of
children, covered under current criminal laws. There is no excuse for adults
engaging in practices that exceed these limits, and state management of
child raising is the only sure method of eliminating the problem. It maybe
that all adults in contact or able to view children, whether live or
remotely through any form of media, will only be allowed such access to
children while wearing electronic brain and genital monitoring equipment in
the near future. This will allow the state to monitor all adults in these
positions for child abuse or exploitation while extracting and prosecuting
all adults engaging in this abuse. All of these acts are serious forms of
child abuse and must be considered criminal under present laws and
prosecuted as contributing to the delinquency of a minor, sexual abuse, and
adult predator activity. Children must be protected by the state from common
abuses being practiced in most families today, and adults advocating the
ideas contrary to the above limits must be removed for all contact with
children, be brought to trial, and receive mental health treatment for
crimes against children and the state.
>
>Examples of this problem is the widespread practice of photographing
children and possessing photos of children (exciting or pleasurable for
adults is the exploitation of children and is covered under current criminal
laws), the availability of diapers for children past the age of 18 months,
bedwetting beyond 18 months, and the practice of breast feeding a child,
especially beyond 12 months of age. It is considered by experts that the age
limits stated here are acceptable limits all children can be expected to
meet in developmental milestones and those not able to meet these limits
must be transferred into the care of the state until such performance is
achieved or where parents have been eliminated from the child's contacts.
The practice of photographing children must be stopped. Photographs and
video images are used by mentally ill adults in pedophile activity and
thoughts, whether consciously or subconsciously held (visually exciting or
pleasurable for adults viewing children is the exploitation of children and
is covered under current criminal laws). Most adults have some level of this
mental problem as evidenced by the number of pictures created today.
>
>The legislative process has been zeroing in on this very serious area of
child abuse and must continue to enact further legislation to remove
children from this treatment and prosecute all adults participating in such
vial acts.
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Date: Fri, 17 Mar 2000 18:41:10 +0100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: ADVOCATING ILLEGAL PARENTING ACTIVITY
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It's a joke, right Kathy? Ain't it? Please?
This is sick if it is not a joke (even if it is a joke I don't think it amuses
me a lot, it certainly is not ''exciting or
pleasurable''). Or is he the men the robot in Bicentannial Man refers to if he
wonders if someone was breastfed or not?
Gonneke van Veldhuizen
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Date: Fri, 17 Mar 2000 12:02:22 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Mary Kay Smith <[log in to unmask]>
Organization: Sinai Health System
Subject: NMAA
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I can get thru with this
http://www.nmaa.asn.au
Mary Kay Smith, IBCLC
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Date: Fri, 17 Mar 2000 09:41:39 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: Hep C
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Re: Hep C policy: In the archives you will find several posts of mine
quoting Dr. Larry Gardner's (expert in Hep C and bf) statements and biblios
on Hepatitis and bf. If you can't find it, let me know and I can re-create
it and post (I'm now on a different computer and the other harddrive is
locked up with unretrievable files).
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Fri, 17 Mar 2000 09:48:03 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: orienteering on mom's chest
Comments: To: [log in to unmask]
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Annelies: Your description of babies locating the nipple sounds like
orienteering on mom's body. I wonder if it's anything like geese flying
south/north and whales migrating along the same path every year for
centuries. Could it be that unless we muck with the process by washing,
drugging, separating, etc. that babies are wired to do this (picture their
own private litte compass with a breast at the N. marker)? I think so.
Remember that in general olfactory or sense of smell in humans is the
strongest sense and taste is very closely related to this.
This brings up a very difficult dilemma about those having hospital
births...we obviously have some serious staph and strep, as well as other
nasties, floating around our hospitals, but it is in m-b dyad's interest not
to have her scent destroyed.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Fri, 17 Mar 2000 12:17:15 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Anne L. Varberg" <[log in to unmask]>
Subject: Re: ADVOCATING ILLEGAL PARENTING ACTIVITY
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Just gotta say, that letter from "John Smith" had schizophrenia written all
over it.
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Date: Fri, 17 Mar 2000 11:57:33 -0600
Reply-To: Lactation Information and Discussion
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From: gima <[log in to unmask]>
Subject: Re: what is this little guy doing?
In-Reply-To: <000201bf8ff8$34bc99e0$185e94ca@Kirsten>
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A big thank you to all of you who replied, both to the list and privately,
to my post about the baby who was doing funny stuff at 5-6 minutes into the
feeding. I shared your thoughts and she came to a conclusion.
She feels that his bahavior fits with the slowed flow after the first MER.
Sometimes when he has jerked off the breast he "forgot" to release the
nipple. She said that she anticipates this event and it is probably
inhibiting the next MER. She added that he hasn't done it at night, when
she is so sleepy, and when she goes to an upstairs bedroom in the day time
to feed alone.
She said that if she is in the den on the sofa and the 4 year old is there,
the phone is ringing, and her husband, who works at home, is busy, and mom
is up tight, it is more likely to happen.
My suggestions, based on some of your suggestions and a few of my own were:
Turn the clock around so that she doesn't see that 5-6 minute time coming.
Stimulate the other nipple to help with the mer.
Take deep, full-body breaths to help her relax as soon as she detects
slowed swallowing.
Use breast compression to assure him that there is more milk and go
facilitate suckling that will initiate an MER.
Take him off the breast when she sees the problem beginning so that he
doesn't hurt the nipple.
And, my tried and true, use Rescue Remedy to aid in a breaking the
conditioned response of her delayed MER. She liked the idea of its calming
effects.
So, you were all most helpful and this mom is most grateful. I also
appreciate your taking time to reflect on something that isn't *major*, but
which subtracts from this mother's enjoyment of feeding her baby.
You're Good!
Pat Gima, IBCLC
Milwaukee, Wisconsin
Mailto:[log in to unmask]
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Date: Fri, 17 Mar 2000 13:01:50 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Becky Krumwiede <[log in to unmask]>
Subject: Re: pumping after 6 hrs. / delayed pumping
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I have lots of questions about this, too. The longer I'm in practice the
more sure I am that I don't know much. We developed a flow chart at our
hospital so the nurses would have something to follow since the LC's aren't
there all the time. If baby has not latched on and fed well by 12 hours, mom
is to start pumping about every 3 hours. If she gets something, we feed it
to the baby (if only drops, we add a few drops D5 to wash it off the sides of
the bottle). If she gets nothing and baby isn't grumbling to be fed, we
don't start feeding baby until 24 hrs. We start with D5 (based mostly on Dr.
Jack's writings and our hope to not have to introduce foreign proteins), but
if still no colostrum or only tiny amounts by 48 hrs. we start a
protein-hydrolysate formula. Despite the fact that we have Medela Classics
and Ameda-Egnell "big pumps," like Jan B. we often have mothers pumping
absolutely nothing for many pumpings. For the life of me I can't figure out
why so many moms get nothing, but others get a half ounce (15 mls) on the
first pumping!
If there were research to support it, I would be *really* happy to have the
babies hanging out on moms chest licking and nuzzling for the first 24-48
hours, but I guess I'm fearful that would compromise the milk supply. We
really don't know, do we?
Denise wrote: <<My other point is preventing engorgement. We all know that
frequent,
effective breastfeeding from birth will prevent engorgement and that not
draining those breasts often enough in the first 48 hours will cause
engorgement.>>
I don't think we know that at all! I see moms with very bad engorgement
whose babies have nursed wonderfully all along. And about a month ago I
wrote into Lactnet about a Hmong mother with very bad engorgement and never
got a response to my question on that one, so I'll ask again: This mother
had been nursing some, but topping baby off with bottles of formula. I made
a home visit and chatted with her recently emigrated mother-in-law, who had
nursed 4-5 children in Laos or Thailand, who had never seen anyone with hard,
tight breasts like that! In their homeland the practice is to not nurse at
all until the milk comes in; someone else wet-nurses the baby until the mom
"has milk." So why, with this practice, do mothers not get engorged? I
wondered whether our Hmong mothers would be better off not nursing at all
until the milk comes in if they're only going to do it sporadically. Perhaps
occasional emptying is more conducive to engorgement than no emptying. Do we
really know? By what we believe to be true, that older Hmong woman should
have seen plenty of engorged breasts in Laos and Thailand!
Becky Krumwiede, RN, IBCLC
Appleton, Wisconsin
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Date: Fri, 17 Mar 2000 18:24:58 +0000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: heather <[log in to unmask]>
Subject: Re: pumping after 6 hrs. / delayed pumping
In-Reply-To: <[log in to unmask]>
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Becky writes:
>If there were research to support it, I would be *really* happy to have the
>babies hanging out on moms chest licking and nuzzling for the first 24-48
>hours, but I guess I'm fearful that would compromise the milk supply. We
>really don't know, do we?
I suppose we don't know....but I'm not sure why we should assume this might
compromise the milk supply. Chances are the baby would suck a bit,
anyway, and that could go down on the charts, if being recorded, as a
feed....anyway, .being close with the baby is physiological. It doesn't
need reseach, does it (though I'm aware that hospitals like to see this
sort of stuff!). Babies don;t have much of a chance of transmitting those
special, little, tiny feeding cues to their mothers if they are in a crib.
What we do have research on is that formula given in the first few days
compromises breastfeeding.
In the UK ONS stats, mothers who give formula in hospital are three times
more likely to be fully formula feeding by two weeks postpartum. There are
other examples, I am sure, of the risks of formula in the early days.
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
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Date: Fri, 17 Mar 2000 10:50:18 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: Honey
Comments: To: [log in to unmask]
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No problem with honey in the mom's food. The problem with honey and babies
is that babies don't have high enough stomach acidity to kill the botulism
spores. Healthy adults not on acid inhibitors/reducers should have no
problem. By the time the spores reach mom's intestines, they are inactive
and certainly would not pass through to her milk. She should, however, make
sure to wash her hands. I've heard of a case where mom used honey in tea
and on biscuits and somehow the honey was transferred via her hands to the
breast and then baby's mouth.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Fri, 17 Mar 2000 14:01:13 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: dental carries
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I have searched the archives and am not finding exactly what I need. A few
weeks ago someone posted that LLL had something new on dental carries and
breastfeeding. I am unable to locate the pamphlet or handout or whatever it
was. I have called LLL and received a fact sheet with only 2 references
related. If anyone has more recent information please e-mail me. I have a 5
year old that is going through extensive dental work. I need to re-educate
the staff at the dentist office. Out of my 6, he is the only one with this
much of a problem. Thanks,
Evonne
"Home- not where you go when you are tired of being nice to people."
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Date: Fri, 17 Mar 2000 14:14:12 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: teaching milk expression
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What video's would you recommend for showing milk expression, hand and use of
pumps? I am teaching alot of classes and most have never seen a breast give
milk. Thanks,
Evonne
"Home- not where you go when you are tired of being nice to people."
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Date: Fri, 17 Mar 2000 14:30:29 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: ", Fran Brenner" <[log in to unmask]>
Subject: Known conditions where BF is contraindicated
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Can you mention the major conditions [certainly not all 60, but the biggies]
aside from HIV, where mothers are told not to breast feed. Can either post
or email privately. Thanks.
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Date: Fri, 17 Mar 2000 21:07:18 +0100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Rietveld <[log in to unmask]>
Subject: Re: teaching milk expression
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Hi Evonne,
I'd recommend the Kittie Frantz video's.
You can find them at: Http://www.geddespro.com
Also we've recently discussed the NMAA video about Hand expressing at Lactnet.
Just check the archives for the right URL.
Regards,
Renate (Who has no financial interest in these video's:-) )
At 14:14 17-3-00 EST, you wrote:
>What video's would you recommend for showing milk expression, hand and use of
>pumps? I am teaching alot of classes and most have never seen a breast give
>milk. Thanks,
>
>Evonne
--------------------------------------------------------------
Renate Rietveld, IBCLC
E-mail : [log in to unmask]
Homepage: http://www.casema.net/~rietveld/index.htm
--------------------------------------------------------------
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Date: Fri, 17 Mar 2000 14:37:31 -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: pumping initiation
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Apropos of the discussion of when to initiate pumping, Pam Hill, et al.
Effects of Pumping Style, J Hum Lactation 1999, 15(3):209-216.
One of the variables of this study was hours from birth to initiation of
breast pumping. "...milk weight group was inversely correlated with number
of hours from birth to intitiation of breast pumping and positively
correlated with both the overall mean weekly frequency (of pumping) and of
kangaroo care." An important conclusion of this study with clinical
implications for those charged with helping moms of compromised infants is
that "...the level of milk production reached by 3 weeks is likely to be
maintained in subsequent weeks." pg 214.
The authors caution that: "For the mother who has made a commitment to
exclusive breastfeeding for several months and is producing <1700 g/week at
week 2, the outlook is grim. Such mothers may need intensive nursing and
pharmacologic intervention." I read this to suggest that getting the milk
supply established in the absence of a normally nursing baby requires prompt
attention in the early postpartum. People have made excellent points in the
interesting discussion of this issue. Mothers do need time to process their
situation emotionally, and we do need to allow the infant time to organize
feeding following birth. However, when it becomes clear (by careful
assessment of the dyad) that the infant is NOT going to be feeding normally
for a while, then protection of the potential for full milk production
capacity becomes a priority second only to making decisions on how to feed
the baby in the meantime.
The study suggests that kangaroo care IS very effective in assisting milk
supply, and indicates that initiation of pumping at a MINIMUM of 6 times
daily -- 8-12 is better (with careful evaluation of supply at week 2) will
provide adequate protection for the mother who is maintaining milk supply
with mechanical expression.
I think it is fabulous that we are starting to have data by careful
researchers to help us make better clinical decisions on such matters.
Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com
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Date: Fri, 17 Mar 2000 14:57:10 -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: pumping and engorgement
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Humenick and Hill published 2 classic articles in J Hum Lact 1994, 10(2) on
the occurance of engorgement. Patterns of engorgement vary, and one
commonly experienced pattern was marked by intense, enduring engorgement
that could persist for up to two weeks. This is a pattern that often
results in greater risk for weaning for obvious reasons, but it did not
necessarily result from mismanagement of lactation (i.e. not feeding/pumping
enough early on). They also discovered that previous breastfeeding
experience was an important variable in predicting engorgement "Second time
breastfeeding mothers experienced engorgement sooner and more severely than
did first time breastfeeding mothers."
I have managed many moms with subsequent babies who were 'super-producers'
with baby #1 who did everything we could both think of to reduce/prevent
engorgement (including keeping colostrum drained) to no avail. They still
got engorged. So I don't think we do "know" that early pumping protects
against engorgement.
Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com
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Date: Fri, 17 Mar 2000 17:19:35 -0500
Reply-To: Lactation Information and Discussion
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From: Kerri Zandberg <[log in to unmask]>
Subject: Polycystic Ovaries and Over supply
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I forgot to mention, in my first post, that about 20% of woman with PCO
have hyperprolactinemia and a percentage have OVER supply. I know Lisa
has posted to the list with experience with PCO and UNDER supply. Just
wanted to clarify.
Kerri Zandberg, R.N., B.ScN., Chatham, Ontario, Canada
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Date: Fri, 17 Mar 2000 17:13:40 -0500
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From: Lorri <[log in to unmask]>
Subject: Re: kneading, oral fixation, weaning, kittens
Comments: To: Chris Hafner-Eaton <[log in to unmask]>
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This is a hoot! I know most cats are quirky but I thought I had the only cat
that does this, though I've always jokingly attributed this sometimes
annoying activity to his early weaning!
Lorri Centineo
>>>>>>>> Chris Hafner-Eaton wrote
Not only have I witnessed the kitten phenom (lifelong kneaders), but I
actually had one cat who used to nurse on my earlobes!
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Date: Fri, 17 Mar 2000 23:42:32 +0100
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: kneading, oral fixation, weaning, kittens
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I have a cat that was taken away from the mother at ab. 5-6 weeks (not sure,
found them at a terrain with big machines, left behind at the start of summer
hollidays :-( ). He always sucks his toe when he is settling himself to sleep!
Gonneke van Veldhuizen
> This is a hoot! I know most cats are quirky but I thought I had the only cat
> that does this, though I've always jokingly attributed this sometimes
> annoying activity to his early weaning!
>
> Lorri Centineo
>
> >>>>>>>> Chris Hafner-Eaton wrote
>
> Not only have I witnessed the kitten phenom (lifelong kneaders), but I
> actually had one cat who used to nurse on my earlobes!
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Date: Fri, 17 Mar 2000 20:03:31 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Patrica Young <[log in to unmask]>
Subject: Re: Honey
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I do not see physiologically or microbiologically how it could get from the
mother's stomach into her milk. Anyone else have any ideas? Sincerely,
Pat in SNJ
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Date: Fri, 17 Mar 2000 20:09:22 -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: Known conditions where BF is contraindicated
Comments: cc: [log in to unmask]
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Fran, where did you get the #60 BF contraindications??? Sincerely, Pat in
SNJ
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Date: Fri, 17 Mar 2000 21:09:13 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Kathy Parkes <[log in to unmask]>
Subject: Re: kneading, oral fixation, weaning, kittens
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In a message dated 3/16/00 9:30:34 PM Pacific Standard Time,
[log in to unmask] writes:
<< Not only have I witnessed the kitten phenom (lifelong kneaders), but I
> actually had one cat who used to nurse on my earlobes! She lived till a
> ripe old age of 26--even with her oral fixation. >>
I had a female cat who would nurse on her own teats, for hours at a time.
It was the only thing that comforted her. Definitely taken from her momma
too soon.
Kathy Parkes, RN, IBCLC
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Date: Fri, 17 Mar 2000 16:37:45 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: The Breastfeeding Center of Maine <[log in to unmask]>
Subject: brewer's or nutrional yeast
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Is there a correlation with eating/drinking nutritional or brewer's =
yeast and breast/nipple yeast infections? I am working with a mom who =
resolved her breast/baby yeast infection in January and after recently =
having 1 tsp. brewer's yeast noticed yeast again in her baby's mouth a =
few days later, and then a few days later on her nipples. She can not =
think of any other contributing factor. She used to use it daily and =
stopped with her initial infection.
Bettina Pearson
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Date: Fri, 17 Mar 2000 22:00:12 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: The Breastfeeding Center of Maine <[log in to unmask]>
Subject: prenatal 'milk blisters'
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I have recently seen a mom about 36 weeks pregnant with a history of =
breast reduction. Through the pregnancy she has developed about 12 milk =
blisters (or so they appear) that are not painful and are clustered on =
each of her nipples. After a hot shower she can pick them off, but they =
recur. She has no breast tenderness or lumpiness and has not noticed =
leaking. When she tried to hand express they came out a bit and =
probably could have been plucked off like little plugs. Anyone seen =
this?
Bettina Pearson
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Date: Fri, 17 Mar 2000 22:20:26 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: The Breastfeeding Center of Maine <[log in to unmask]>
Subject: spherocytosis and primary lactation failure?
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Here is a follow-up to my 3/13 posting on 'lactation failure'.
The mom I wrote about was 3 days postop from her second c/s and very =
upset about her milk not coming in, like it didn't last time. She was =
able to express drops at that time and today states she can get 15cc. =
She started reglan and after 2 doses stopped because of diarrhea. She =
is not taking fenugreek. She will not use the SNS but is using 10cc =
syringes with cut off feeding tubes (about 2 inches long) and plans to =
do so another week then reevaluate. She is convinced that her =
spherocytosis is the reason for her suppressed lactation. What do you =
think? She and both her sons have the same condition necessitating =
removal of the spleen. Having something other than herself to blame is =
helping her process alot of angry energy.
By the way, thanks Heather and Diane for your responses to the original =
post!
Bettina Pearson
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Date: Fri, 17 Mar 2000 23:02:05 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Jeanette F. Panchula" <[log in to unmask]>
Subject: osteogenesis imperfecta
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Sorry not to answer sooner, but had to check mom's chart to be sure, as I=
only did a home visit for "reassurance" as the Public Health Nurse had do=
ne
such a great job that baby and mom were doing wonderfully. I only made a=
visit to reassure the PHN - the mom was doing great!
Not only does this mom have Osteogenesis imperfecta, but she also was bor=
n
with a bladder outside her abdomen, so that now she has a ureterostomy. =
She was worried as at times there is some "leaking". =
My suggestion on the leaking - use a rubberized pad under the baby - like=
I
used under all my kids (the cloth diapers never held the stools in well,
and whenever they breastfed I would have to change MY clothes if I didn't=
...) to protect the baby's skin.
AND baby's tongue has a frenulum that is "borderline" - as there was no
pain, I said nothing - and baby is gaining beautifully, =
A few weeks later, I got a note from the WIC Nutritionist (a man) concern=
ed
about seeing that the baby was tongue-tied and asking for my evaluation. =
I
was so pleased to know he was looking! It feels like I'm doing my job so=
me
days - I'd rather be called and provide additional information than have =
no
one notice and no one refer when there ARE problems...
In summary, this mom did not have problems with breastfeeding, however, =
I
have recommended that she begin using the cloth baby carrier early to hel=
p
her with carrying and coping with this fast-growing baby.
Jeanette Panchula, BSW, RN, IBCLC
Vacaville, CA
mailto:[log in to unmask]
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Date: Fri, 17 Mar 2000 23:47:55 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Marlene Wark <[log in to unmask]>
Subject: Re: LACTNET Digest - 17 Mar 2000 - Special issue (#2000-350)
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Date: Fri, 17 Mar 2000 23:11:28 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Sara D. Furr" <[log in to unmask]>
Subject: Known conditions where BF is contraindicated
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Fran wrote >>Can you mention the major conditions [certainly not all 60, but
the biggies] aside from HIV, where mothers are told not to breast feed.<<
You may find the information contained in Ruth Lawrence, M.D.'s publication,
"A Review of the Medical Benefits and Contraindications to Breastfeeding in
the United States" (Maternal and Child Health Technical Information
Bulletin) published by the National Center for Education in Maternal and
Child Health helpful. You can find it online at:
http://www.nmchc.org/html/FullText.htm
Sara Dodder Furr, MA, LLL Leader
Lincoln, Nebraska
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Date: Sat, 18 Mar 2000 01:00:56 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: Chocolate
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In a message dated 3/15/00 3:41:20 PM US Mountain Standard Time,
[log in to unmask] writes:
<< Actually, it could be classified in the "5-a-day" vegetable quota--since it
comes from a bean! >>
Does that mean its OK to eat with Gestational Diabetes after all???
Just kidding-but feeling very deprived. Cant wait to have this baby.
Cheryl Tompkins CLC
Phoenix AZ USA
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Date: Fri, 17 Mar 2000 22:41:44 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Linda Rosetti <[log in to unmask]>
Subject: IlCA Conference Schedule...Reply needed ASAP
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Help...why hasn't the schedule for the conference been posted yet on the
ILCA website. I need to make flight and family arrangements, but I can't
seem to get a hold of anyone. If anyone knows any details about the
schedule for the last day could you Email me.
Thanks
Linda Rosetti
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Date: Fri, 17 Mar 2000 22:58:32 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: To Bf or Not: PKU, Galactosemia & Rare disorders
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For those who have access to LLLI LEAVEN, when I was the Research Review
Committee Coordinator, I published an article entitled: "TO Breastfeed or
Not: PKU, Galactosemia, Other Rare Disorders and Possible Misdiagnosis."
LEAVEN Aug/Sept 1998: pp. 78-79. In this article, I state that PKU does not
preclude bf, but galactosemia does. Following publication of this, there
has been some evidence suggesting that if the infant is monitored closely,
even galactosemia babies might be bf candidates. Indeed, it is truly a rare
situation that contraindicates breastfeeding. IMNSHO, the data are not
entirely clear for HIV, especially in developing nations where the infant
mortality rate for formula-fed infants is 2.9/3.0 (Dettwyller).
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Fri, 17 Mar 2000 23:06:24 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: prenatal milk blisters, milk strands, yeast, lecithin
Comments: To: [log in to unmask]
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Bettina: I'd be curious to see what would happen if this mom expressed milk
while in the bath tub. In the moms in my current study, I have seen strands
of thickened milk (later cultured positive for various yeast strains)
expressed into the water. It is extraordinary to see these spray out in
slow motion. Even in cases where moms were assymptomatic, but babies had
symptoms, there was positive response to a full-scope attack on the yeast
(as I've previously described) including the use of lecithin. The lecithin,
along with vitamin C and other therapeutics, nearly eliminated these
strands. I haven't published these findings yet, but I do have statistical
significance at p=0.05 (so far, and I hope to do better). If you are still
following this patient, I would use Amir's questionnaire to screen for risk
of Candidiasis--although I wouldn't rule out other fungal infections if
she's at risk for this.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Sat, 18 Mar 2000 09:08:13 +0200
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Pamela Morrison IBCLC <[log in to unmask]>
Subject: Contraindications to breastfeeding
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Fran wrote, "Can you mention the major conditions [certainly not all 60, but
the biggies] aside from HIV, where mothers are told not to breast feed."
The l8 hour BFHI course (yellow manual, page 86) lists only seven
'Acceptable medical reasons for foods other than breastmilk' -
1) mother with active herpes lesion on breast/nipple
2) 3) and 4) all relate to HIV but stress that where the use of safe
alternatives to breastfeeding is not possible then breastfeeding should
continue to be the feeding method of choice,
5) mother who has severe psychosis, eclampsia or shock
6) mother who is taking cytotoxic, radioactive or anti-thyroid drugs other
than propylthiouracil and
7) mothers who specifically refuse to breastfeed.
Other than the above, I don't believe there are any *medical* reasons for
not breastfeeding. Furthermore, the wording for reasons (1), (5) and (6)
implies that these contraindications are usually of a temporary nature, ie
when the herpes has healed, or when the mother recovers from the psychosis,
or when the drug is discontinued, then the mother can resume breastfeeding
and she should be helped to maintain her breastmilk production in the
meantime.
I hope this helps.
Pamela Morrison, Zimbabwe
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Date: Sat, 18 Mar 2000 18:37:01 +1000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Virginia G Thorley <[log in to unmask]>
Subject: Impetigo and nipples
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Hello Lactnetters,
I have temporarily mislaid a reference I need, a case report on =
impetigo on a nipple. From memory, it dates from 18 months to 2 years =
ago. Can any one help? I'd appreciate that.
As I am mostly NO MAIL, please email me privately.
Virginia
Virginia Thorley
in Brisbane, Queensland
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Date: Sat, 18 Mar 2000 23:00:17 +1100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Grant & Louise McLeod <[log in to unmask]>
Subject: Re: pumping
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We use the Medela Lactina and also Ameda But not until milk is in - =
before that midwife or mum hand express 6-8 times a day. And I agree =
with Denise it is rare that a mum will get *no* colostrum/milk *at all* =
after expressing 7-8 times.
Is it just a language thing or when you all from USA say "pump" 6 hours =
after birth or whatever, do you mean express milk OR actually use an =
electric pump?
I've got used to other things such as calling breastfeeding "nursing" =
which in oz means more to be holding or cuddling the babe. E.g.. big =
brother and sister will come to visit a sibling and fight over who will =
nurse the baby first.
=20
Louise Dimmock McLeod=20
RN Midwife IBCLC
[log in to unmask]
"The cure for anything is salt water - sweat,tears or the sea"
Isak Dinesen
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Date: Sat, 18 Mar 2000 10:55:27 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: Solids
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<< And they are ready when they try to grab food and put it in their mouths.
>>
Both of my kids have shown advanced gross motor skills, early reaching,
walking, swimming, climbing, etc. My fair little girl has shown my sister's
tendency towards sensitive skin and had more eczema than I would have
expected from an exclusively bf baby (dairy in my diet was partly
responsible). She was reaching and grabbing food from 5 to 8 months and then
having diaper rashes and stomach upset. That was the first of many signs
that she would be "ready" for certain things before she was really
prepared/equipped to handle them (the teenage years will be interesting!).
I'm thinking that with #3 I will intentionally try to hold off solids until a
"date on the calendar" to allow the intestinal/immune readiness to catch up
with the motor skills (and I'll give up the frozen sugared bovine
secretions). Someone posted about giving a spoon, other suggestions or
comments are welcome (private email please).
Elaine Ziska
Jackson, MS
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Date: Fri, 17 Mar 2000 16:51:45 +0200
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Jean Ridler <[log in to unmask]>
Subject: Re: 6 hour pump reference
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This thread has taken a couple of interesting turns. When to intervene when
a healthy newborn is not nursing?
One study that I found interesting by Yamauchi and Yamanouchi (1990)
showed that healthy, full-term breastfeeding babies fed:
4.3 times in the first 24 hours (range 0 - 11)
7.4 times in the next 24 hours (range 1 - 22)
(Sorry, I can't find the full reference at the moment - the above I got from
an OH transparency I made a while back.)
Riodan and Auerbach (p283-284) refers to the first day sleep patterns of
neonates born in hospital and this seem to correlate well with the above
study.
Especially if the baby has fed at least once, preferably in the hour
or so after birth, I don't see any reason to panic until the second day. In
the meantime plenty of skin-to-skin contact can be encouraged. *Sometimes*
the mom feels better if we express (by hand) a couple of mls of colostrum
and give it
to baby. This sometimes has the affect of waking up the baby. What often
happens here is that the staff insist that baby must be fed every 4 hours
and this results in lots of heel flicking and shoving and pushing at the
breast which distresses the mother greatly and is not appreciated by the
baby! I find no increase in engorgement provided mother feeds baby
frequently on cue from the second day (and night) onwards. In fact they seem
to do much better than the moms on the hospital's preferred 4 hourly
routine
Jean Ridler RN RM IBCLC
Cape Town, South Africa
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Date: Sat, 18 Mar 2000 19:58:06 +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: 6 hour pump reference
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snip
> One study that I found interesting by Yamauchi and Yamanouchi (1990)
> showed that healthy, full-term breastfeeding babies fed:
> 4.3 times in the first 24 hours (range 0 - 11)
> 7.4 times in the next 24 hours (range 1 - 22)
snip
> Riodan and Auerbach (p283-284) refers to the first day sleep patterns of
> neonates born in hospital and this seem to correlate well with the above
> study.
snip
This makes me wonder: are there any studies done on healthy newborns in a
non-medicated, non-hospital setting. I wonder if any of us really *knows* what
normal sleeping-feeding behaviour is of newborns in a *natural* setting,
(meaning non-medicated birth in a non-hospital/institional setting), whit mom
and baby not separated and both healthy. And what effect on short and long term
milksupply this sleeping-feeding behaviour has. Does anyone out there know?
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
http://www.users.skynet.be/eurolac
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Date: Sat, 18 Mar 2000 21:07:18 +0200
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Susan & Moshe Srebrnik <[log in to unmask]>
Subject: postpartum depression study
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There is an article in the February 8, 2000 edition of the American
Journal of Psychiatry on the use of the SSRI paroxetine (Paxil, Seroxat)
in breastfeeding women.
According to a new study by Emory University, Paxil "is a viable
treatment option for mothers who would like to continue breastfeeding."
Susan Nachman-Srebrnik, IBCLC
Ranana, Israel
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Date: Sat, 18 Mar 2000 08:55:19 -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: sharing pumps
Since there is no data out there to say that moms should not share pumps,
then why do we tell them not too? ?
In reply to my post last week, I received 1 reply from someone that works at
CDC and she says they never issued a statement to that effect. I cant find
anything in the archives or on a lit search that says that moms should not
share pumps due to health reasons?
So is the conclusion, that if moms boil the collection parts then it IS ok??
Thanks!
Cindy Curtis,RN,IBCLC
mailto:[log in to unmask]
http://www.erols.com/cindyrn
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Date: Sat, 18 Mar 2000 21:50:19 +0200
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: The Curries <[log in to unmask]>
Subject: Pacifiers.
Hello All,
I read somewhere that pacifiers (as well as bottles) can cause otitis
media. I am aware of two b/f babies, who both have dummies, that have had
repeated otitis media and have had grommets put in. What is the mechanism
behind the dummy (SA term - Yuck) use and otitis media? Can someone
comment please.
TIA
Sincerely,
Barbie Currie. RN RM White River, South Africa.
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Date: Sat, 18 Mar 2000 11:48:53 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: pumping usually not expressing
Comments: To: [log in to unmask]
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Louise: My take on the pump thing is that most of the hcps here never teach
manual expression and they automatically hand over an electric pump. Few
people here know how to teach manual expression even though Marmet's
Technique is effective and available on LLLI tear-off sheets.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Sat, 18 Mar 2000 14:40:07 -0500
Reply-To: Lactation Information and Discussion
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From: "Kathleen Buckley, RN, IBCLC" <[log in to unmask]>
Subject: breast abcess
I am seeing a woman who has recently had a breast abcess. It was open and
drained by the surgeon. There are now two incisions on the breast each
about 2 cm long, 1/2cm wide and 7-8 cm deep. I am cleaning them with
normal saline, packing each with idophor gauze (1/2" strips) and covering
with a dry sterile dressing. There is small to serous moderate drainage
from each. This is being done twice a day and is very painful for the Mom
despite her medicating herself with Tylenol with Codeine prior to the
dressing change. She says the iodophor gauze stings and that causes her
the most pain.
I want to know if this is the most current way of handling a breast abcess
wound or would it be better to use a hydrogel or calcium alginate covered
with a transparent dressing. I know these dressings can be left up to 3
days depending upon the type of drainage. This would made a considerable
difference in reducing her pain.
Has anyone used either of these methods or are you aware of any papers
which discuss this type of wound and using any of the above methods?
Could greatly appreciate your help.
Kathleen Buckley, RN, IBCLC
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Date: Sat, 18 Mar 2000 14:53:01 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Ann Perry <[log in to unmask]>
Subject: contraindications to brfdg
Comments: cc: [log in to unmask]
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Hi Fran,
I don't know what you are referring to when you say the 60 items
contraindicating breastfeeding but I have an excellent paper you can get the
information from.
"A Review of the Medical Benefits and Contraindications to Breastfeeding in
the United States" by Ruth Lawrence.
You can obtain this by writing to: National Maternal and Child Health
Clearinghouse,
2070 Chain Bridge Road, Suite 450, Vienna, VA 22182-2536
or call: (703) 356-1964
or fax: (703) 821-2098
Ruth gave a presentation on this paper at ILCA 1997. The summary of the
paper; there is no clear cut contraindication to breastfeeding, each case
should be evaluated on a risk/benefit basis.
It is excellent and I highly recommend it. Comes in handy when a clinician
ask you for information and a reference.
Ann Perry RN IBCLC
Boston, Mass
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Date: Sat, 18 Mar 2000 15:12:18 EST
Reply-To: Lactation Information and Discussion
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Subject: contraindications to BF
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Dear Friends:
Based on AAP recommendations and Lawrence's publication Medical
Contraindications, only women who are HIV+, or have HTVL , or who have
partners HIV+ and/or IV drug using are proscribed from breastfeeding in the
USA.
All other conditions: chickenpox, tuberculosis, herpes, radioactive
isotope use may require temporary weaning and pumping/dumping.
Warmly,
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: Sun, 19 Mar 2000 06:22:55 +1000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Denise Fisher <[log in to unmask]>
Subject: no milk removal and engorgement
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This is in response to a posting from Barbara W-C regarding our knowledge
of the causes of engorgement (or rather lack of knowledge...). I have
discarded the original posting so please correct me Barbara if I am
misunderstanding you.
I had previously mentioned that we 'know' that good, regular removal of
milk from the breasts in the first 48 hours or so will reduce the chances
of developing engorgement when lactogenesis II occurs. Barbara refuted this.
Am I to understand you are saying that there is nothing we can do in our
breastfeeding management that will have any impact on the 'severity' of
engorgement?
I don't have any research on me at the moment (I'll definitely be looking
as soon as I can) but my experience leads me to disagree. The women whose
babies are sleepy and breastfeed 4 to 5 hourly in those first few days do
experience significantly more engorgement than the ones whose babies are on
and off the breast all day and all night.
I know there are exceptions to every rule - and yes I agree that some women
(but a minority) will get engorged, and possibly quite severly so, despite
the very best of management. But I do suggest that these women are
exceptions.
What has others experiences been?
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: Sat, 18 Mar 2000 15:48:13 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: Sharing pumps
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Cindy,
If a mom properly cleans and sterilizes a hand pump, why not? We are smart
people. We are capable of correctly sterilizing things with some
instruction. Now some of the electric pumps pose a different problem with
possible milk that could have gotten into the motor and could breed germs. I
think each situation has to be evaluated independently.
When my mother worked as a nurse, in the 30's and 40's, they had glass
syringes with stainless steel needles and hubs. They resterilized them all
the time. It is the pump companies that don't want any liability in our
"law suit happy" society, and I can't blame them. If they say not to share a
used pump and someone does, it is on the mother's own liability, not that of
the pump company. I don't blame the companies, but think it is a terrible,
terrible waste for a perfectly good pump, not one of the painful/poor
quality/junk pumps, to be thrown away and not recycled through another
mother, when all she needs to know is how to properly scrub and boil it.
Jane Bradshaw RN, BSN, IBCLC
(The most avid recycler in the state of Virginia)
Reduce--Reuse--Recycle!!!!!!!!!!!!!!!!!!!!
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Date: Sat, 18 Mar 2000 14:00:22 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Wendy <[log in to unmask]>
Subject: sharing pumps
Comments: To: [log in to unmask]
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Dear Cindy,
In the case of the Pump in Style, I recommend that if a mom shares, she
must take a close look at the tubing.
If the tubing has black spots (mold), then I suggest that she not share
this pump. Most likely the original owner had milk backing up into the
tubing.
According to Medela, if it gets into the motor, bacteria can form and can
be reintroduced into the freshly expressed milk. Unfortunately, there is no
way to sterilize this.
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Date: Sat, 18 Mar 2000 16:18:12 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: Re: expressing milk
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Just a note...I do notice that mothers who leak prior to delivery have
atleast better expression than those that do not.....and that applies to
multips and primips.
Sharon Lemon
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Date: Sat, 18 Mar 2000 21:23:51 -0000
Reply-To: Lactation Information and Discussion
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From: Magda Sachs <[log in to unmask]>
Subject: routine growth monitoring
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The 1999 update of the Cochrane trial is now transmogrified into an article
in the March issue of the Archives of Disease in Childhood (the journal of
the Royal College of Pediatrics and Child Health): Is routine growth
monitoring effective? A systematic review of trials. Garner, P,
Panpanich, R Logan, S ADC 2000 82 197-201
In addition to the article is a Commentary by Prof DP Davies, who has won
his way into my heart with his words: "I wonder whether the measurement of
weight...should be an investigation of possible abnormality rather than a
routinely carried out primary clinical measurement as -- for example, the
measurement of haemoglobin where anaemia is clinically suspected? Perhaps a
lot of good practice does go on where benefit is conferred but, if so, what
a pity it is not published so that doubts can be dispelled.
"Comments over many years from mothers who have derived little satisfaction
from regular weighing, and who have sometimes suffered unneccessary worry
support my anxieties.
"However strong might be the academic arguement against the clinical ritual
of growth monitoring, I will have to conceed (with some reluctance) that
babies will continue to have their weight gain monitored. (It would take
more than an Act of Parliament to stop it!).........Why should the current
renaissance of interest in the value of clinical effectiveness not apply to
this most commonly used simple proceedure. But I doubt somehow there will
be much support for such studies. I wonder whether they would ever pass
ethics committee scrutiny, so fixed are we in our biases. I will, however,
continue to question the ethics of persisting with a clinical procedure,
which is of unproved benefit, and with a capacity to do harm."
Pretty amazing stuff from a professor -- not only does he focus in on the
quality of the weighing expereince for care-givers, especially mothers, but
he talks about the *ritual* of weighing, which usually only gets described
as such in the more qualitative and ethnographic research.
I am trying to compose a fan letter!
Magda Sachs
Breastfeeding Supporter, BfN, UK
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Date: Sat, 18 Mar 2000 16:29:16 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Johanna Berger <[log in to unmask]>
Subject: ADVOCATING ILLEGAL PARENTING ACTIVITY
Comments: To: [log in to unmask]
Hmmmm.....sounds like a borderline and/or paranoid schizophrenic to me.
Perhaps has some pedophillic issues he's trying to suppress...
Ah well, just the social worker in me :-)
Johanna Berger, LSW
Breastfeeding Counselor
Bala Cynwyd, PA
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Date: Sat, 18 Mar 2000 16:07:46 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Johanna Berger <[log in to unmask]>
Subject: mittens
Comments: To: [log in to unmask]
Very interesting... My mother tells the story that she always had mittens
on my hands after I was born because I would scratch my face. My
great-grandmother saw this and through a fit because, she said, I
wouldn't be smart if my hands were covered up. Insisted my mother remove
the mittens and get rid of them.
A bubbemeise (as we say in my family)? I have seen research that
suggests infants learn by feel.
Johanna Berger, LSW
Breastfeeding Counselor
Bala Cynwyd, PA
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Date: Sat, 18 Mar 2000 21:49:36 -0000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Magda Sachs <[log in to unmask]>
Subject: contraindications to breastfeeding
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Chris said: Indeed, it is truly a rare
situation that contraindicates breastfeeding. IMNSHO, the data are not
entirely clear for HIV, especially in developing nations where the infant
mortality rate for formula-fed infants is 2.9/3.0 (Dettwyller).
The data are certainly far from clear with HIV+ women who choose to
breastfeed. So far we have one study (actually, maybe there was one
previous one in Zaire -- anyone have that reference off hand?) which
differentiated between EXCLUSIVE BREASTFEEDING, EXCLUSIVE REPLACEMENT
FEEDING and *MIXED FEEDING* -- where *exclusive* breastfeeding means not
just that no other non-human milks were ingested by the baby but that
NOTHING else passed the baby's lips except for medications. So, no water,
no teas, no gruels, no pre-lacteal feeds, no odd bit of potato chip (crisp,
we would say), banana, mealie-meal porridge, etc, etc. This study
(Coutsoudis et al, 1999 The Lancet) showed that the exclusively breast-fed
babies had an early transmission rate similar to that of replacement fed
babies, while the mixed fed babies had the higher rates. Coutsoudis's
further results will be published in due course.
Incidentally no study has examined the morbidity of babies born to HIV+
women. The only marker usually looked for is whether the babies test + or -
on an HIV antibody test of some kind. The recent Nduati study did say that
the authors plan to publish more info on their mortality stats and on the
morbidity of the children in their study (JAMA 1 March 2000), but don't know
when those will appear. And what quality they will be.
I have to say that I don't think the evidence available justifies saying
that a woman's HIV+ diagnosis is a contraindication for her to breastfeed,
no matter which part of the globe she lives in. Of course, she may believe
otherwise, and, so far we still have some committment to the fact that women
do have the ultimate choice (the UK govt grudgingly accepts that in its
publication, HIV and Infant Feeding, though the same page carries a veiled
threat).
It seems totally bizarre to me that I have had people being quite shocked at
the idea that someone who is HIV+ might choose to breastfeed her baby, when
we don't know the risks and she might be putting her baby in danger, when
EVERY DAY we meet women and tell them that the important thing is
establishing a relationship with their child, making a decsion they are
happy and feel comfortable with and that 'perfect, optimal' nutrition is not
the only part of being a good mother. How come it is right to do this for
ordinary replacement feeding but not when an HIV+ woman chooses to
breastfeed?
Magda Sachs
Breastfeeding Supporter, BfN, UK
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Date: Sat, 18 Mar 2000 09:30:46 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Julius Edlavitch <[log in to unmask]>
Subject: Lactation Chat and Special Webtour
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Monday Night March 20th Jack and Kay will discuss
BREASTFEEDING
Lactation Chat at 9 PM Eastern USA time Monday Nights
With Kay Hoover MA ED and Jack Newman MD
*********************************************************************
This is a webtour I thought you may enjoy participating in
Tuesday March 21th 9pm NY time
"The Impact of War and Conflict on Women and Children"
Anna Mandalakas MD Case Western University
Rainbow Center for International Child Health
http://www.pedschat.org/anna/
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Date: Sat, 18 Mar 2000 11:12:28 -0400
Reply-To: Lactation Information and Discussion
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From: Diane Wiessinger <[log in to unmask]>
Subject: gentian violet for digits?
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Does gentian violet work on fungi besides Candida? I got to thinking about
the fingernail/toenail fungus that some people - including some of my
extended family - have, that supposedly can be cleared up only with many
months of systemic fungicide. And yet... if you ask most of the medical
profession, the preferred treatment for thrush is the one that's more
complicated to use, less effective, more expensive, and requires a
prescription. Could it be that humble gentian violet works on nails as well
and just doesn't have a good marketing plan?
As an experiment, and because I have a suspect toe myself, I've cut the nail
as shortshortshort as possible and painted with gv, and have urged my
pinky-infected nephew to consider the same. I plan to do so daily for a few
weeks at least. But do the wise heads of lactnet know whether this is a
silly venture, or whether the gv will indeed work if we can get it far
enough under the nail?
Diane Wiessinger, MS, IBCLC Ithaca, NY
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Date: Sat, 18 Mar 2000 23:25:01 +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: no milk removal and engorgement
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> I know there are exceptions to every rule - and yes I agree that some women
> (but a minority) will get engorged, and possibly quite severly so, despite
> the very best of management. But I do suggest that these women are
> exceptions.
>
> What has others experiences been?
Denise,
My experience (from observations and client records) is that engorgement is more
common when breast emptying is not frequent in the first days OR if it is
frequent *with* frequent breast-switching. I also have the impression that
''multilacties'' tend to develop engorgement more easy and more severe. I do not
know wether this is due to the glands be more ''experienced'' and thus make more
milk sooner or that it is because mom is slightly more unsecure in management.
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
http://www.users.skynet.be/eurolac
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Date: Sat, 18 Mar 2000 17:44:13 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Rhonda Feder <[log in to unmask]>
Subject: Sharing Pumps
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In a message dated 3/18/2000 5:15:03 PM Eastern Standard Time,
[log in to unmask] writes:
> In the case of the Pump in Style, I recommend that if a mom shares, she
> must take a close look at the tubing.
> If the tubing has black spots (mold), then I suggest that she not share
> this pump. Most likely the original owner had milk backing up into the
> tubing.
>
> According to Medela, if it gets into the motor, bacteria can form and can
> be reintroduced into the freshly expressed milk. Unfortunately, there is no
> way to sterilize this.
How does this relate exclusively to sharing pumps -- it seems to me that if I
saw black spots from my own milk in the tubing, I should assume milk has been
backing up and bacteria may be formed -- is my bacteria okay but my friends
not? That doesn't make any sense -- I used the pump over 2 years ago and
plan to use it again, but surely if anything got into the motor, it wouldn't
much mater at this point whose milk it was -- it would be bad. Maybe I
should contact Medela and ask them what to do?? Any thoughts?
Please email to me in addition to Lactnet, as I am not getting to all the
messages lately. Thanks.
Rhonda Feder
Elkins Park, PA
lawyer & lay counselor
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Date: Sat, 18 Mar 2000 18:04:27 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Carol Brussel <[log in to unmask]>
Subject: pump sharing
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<< According to Medela, if it gets into the motor, bacteria can form and can
be reintroduced into the freshly expressed milk. Unfortunately, there is no
way to sterilize this >>
so why don't we have disposable "hospital grade" pumps? if this is true, is
it not true for the ones we routinely use in the hospital (mom comes in, puts
on her kit, pumps, next mom comes in, etc.) or that we rent? i don't handle
the rental part, so i don't know the routine, i have heard other rental
people say they sterilize the pump and clean it, etc., between rentals (good
idea) but i have also seen moms in the hospital go to the "pumping room" and
sit down and use a pump, and no one is standing at the ready with cleaning
and sterilizing equipment.
or to throw it away and put out a fresh one for the next user.
carol brussel IBCLC
hearing the words "marketing strategy" and "CYA" loud and clear
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Date: Sun, 19 Mar 2000 00:17:28 +0100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: Rietveld <[log in to unmask]>
Subject: Re: no milk removal and engorgement
In-Reply-To: <[log in to unmask]>
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Hi Denise,
My overall experience is the same as yours is: With proper breastfeeding
management engorgement seems to be less severe. Ofcourse there are always
exceptions.
Renate.
At 06:22 19-3-00 +1000, you wrote:
>This is in response to a posting from Barbara W-C regarding our knowledge
>of the causes of engorgement (or rather lack of knowledge...). I have
>discarded the original posting so please correct me Barbara if I am
>misunderstanding you.
>
>I had previously mentioned that we 'know' that good, regular removal of
>milk from the breasts in the first 48 hours or so will reduce the chances
>of developing engorgement when lactogenesis II occurs. Barbara refuted this.
>Am I to understand you are saying that there is nothing we can do in our
>breastfeeding management that will have any impact on the 'severity' of
>engorgement?
>I don't have any research on me at the moment (I'll definitely be looking
>as soon as I can) but my experience leads me to disagree. The women whose
>babies are sleepy and breastfeed 4 to 5 hourly in those first few days do
>experience significantly more engorgement than the ones whose babies are on
>and off the breast all day and all night.
>
>I know there are exceptions to every rule - and yes I agree that some women
>(but a minority) will get engorged, and possibly quite severly so, despite
>the very best of management. But I do suggest that these women are
>exceptions.
>
>What has others experiences been?
>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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>
--------------------------------------------------------------
Renate Rietveld, IBCLC
E-mail : [log in to unmask]
Homepage: http://www.casema.net/~rietveld/index.htm
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Date: Sat, 18 Mar 2000 18:10:45 -0500
Reply-To: Lactation Information and Discussion
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From: Patrica Young <[log in to unmask]>
Subject: Re: breast abcess
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I don't think the incisions need packing. How do others feel about this?
Sincerely, Pat in SNJ
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Date: Sat, 18 Mar 2000 18:46:17 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: catheters and infection
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My sister gave birth to her third son about 11 days ago. He is nursing like a
champ!
I have a quick question. Her first child she got a catheter during the
epidural and after the birth got a urinary infection. Her 2nd child she
started antibiotics after the birth and did not get an infection.
This child was her first VBAC. She did get an epidural and catheter. 2 days
ago she started complaining of back pain. Now she has a temp. and was
admitted back to the hospital. They decided it was a urinary track infection
of some sort and she is on antibiotics. The nurses were telling her not to
nurse (because of the fever). I let her know it was O.K. to nurse the baby.
He is rooming in with her.
I am having her follow an anti-yeast diet while on the antibiotics. She seems
prone to thrush.
Are there many moms that get infections like this after using catheters?
Thanks,
Annette L.
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Date: Sat, 18 Mar 2000 15:44:33 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: abscess and hydrogel
Comments: To: [log in to unmask]
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Kathleen: My first question would be to ask whether there are any necrotic
tissues remaining around the excised abscess area? If so, I would NOT go
the hydrogel route until these are clear. Given that you said the exudate
is serous, I'll assume that means the infection has been successfully
cleared. In this size wound, if infection is gone, I've found the best
management is to cover it with hydrogel and leave it alone as long as the
exudate is not floating the hydrogel off it (which frequently happens until
the wound is very small). The problem with the iodophor is that it is
disrupting the new cellular growth lining the wound and you or she are
ripping the new cells out regularly in the name of cleaning (not your fault,
it's what we were taught). In addition to changing the routine, there is
significant evidence that 200 mg of zinc has exceptional ability to heal
wounds of this kind (see the burn lit). As soon as the wound starts to
granulate (fill in), I would start using a product like Lansinoh on it and
have it remain clean and covered in between showerings. Once they start to
close, it's only a matter of a day or two.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Sat, 18 Mar 2000 15:54:00 -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: engorgement
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Denise: First, I should state that for the most part, I do not work with
NICU babies unless the hospital staff or parents have called me in and that
means usually several days have passed). My experience has been that most
moms don't have mature milk in the first 48 hours--they have colostrum and
then transitional milk--and that any engorgement occurs later. Believe it
or not, my experience has actually shown that the use of electric pumps
(good, hospital grade Medela or A-E) have even exacerbated this by "getting
things going" too soon for baby to really drain the breast. I know this
isn't going to fly with a lot of the hospital based LCs, but it's what I
see.
I use a 24-48 hour rule of watch and see, encouraging lots of skin-to-skin,
snuggling, smelling (very important in prolactin levels), licking, baby
massage, etc before introducing expression in large quantities (and I do
encourage the use of Marmet's technique with hands on teaching). I do
encourage the use of small amounts of hand expression of colostrum to entice
the baby to lick the nipple and areola. When I am involved from the very
beginning, the rate of engorgement is less than 5%, so I have to believe
that this technique has worked and that we don't need to be pushing the
pumping so early.
On the other side, I DO get lots of calls for engorgement because of
mismanagement, including giving babies supplementary feedings which make
them less interested in the breast.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Sat, 18 Mar 2000 16:04:25 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: amazing stuff from a "professor"
Comments: To: [log in to unmask]
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Hi Magda: Thanks for sharing that great piece on growth monitoring...I just
want to gently and kindly point out that there are several of those
"professorial" types on Lactnet (believe it or not). We really do try hard
to spread the word in the research community and need the support of all
practicing LCs and bf supporters. As a Amer. Public Health Assoc. Medical
Care section governing councilor, I had to publicly critique, respond and
vote on policy being adopted by the APHA. It was shocking to me that after
several hearings, practitioners (some midwives, obs, peds, IBCLCs) came up
to me and said "WHERE DID YOU COME FROM??? We've never had anyone so
<progressive>, <liberal>, <informed about MCH> <<fill in the blank>>" These
votes were on issues of the use of midwives, breastfeeding and infectious
diseases, employers and bf, etc. I have to say that the assumption was that
because I was there as a research academic (they didn't realize that I had a
private practice), that my head was in the sand (or somewhere even darker).
So please DO write Dr. Davies a fan note...I'm sure he will really
appreciate it.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Sat, 18 Mar 2000 18:17:26 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Alicia <[log in to unmask]>
Subject: Re: 6 hour pump reference
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Gonneke wrote:
>This makes me wonder: are there any studies done on healthy newborns in a
>non-medicated, non-hospital setting. I wonder if any of us really *knows* what
>normal sleeping-feeding behaviour is of newborns in a *natural* setting,
>(meaning non-medicated birth in a non-hospital/institional setting), whit mom
>and baby not separated and both healthy. And what effect on short
>and long term
>milksupply this sleeping-feeding behaviour has. Does anyone out there know?
I don't know of any studies, but, I can give my own personal
experience. My second child was born at home in my bed at 5:07pm. I
got cleaned up and our midwife went out and got some dinner for us -
they bed sheets got changed. I climbed back into bed with our new
little girl - I remember her breastfeeding off and on during the
night even when her brother came into our bed and wanted her out of
"his" place (between mom and dad). I also remember the midwife being
surprised how much my uterus had shrunk - I wasn't surprised because
I was feeling the after pains - especially when Samantha breastfed.
So, I don't know if my experience us the usual one, but, that's what
happened to us!
Alicia Rudin, LLLL in the Bluegrass (Lexington, KY)
mailto:[log in to unmask]
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Date: Sat, 18 Mar 2000 18:31:09 -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: engorgement
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Hi Denise, We don't disagree. There most certainly IS iatrogenic
engorgement caused by poor management, or resulting from a poorly latched or
weakly nursing infant. We've all seen this. So obviously, we can
contribute with education on good latching and on freq. early feeds. The
Hill and Humenick data, and my comments were more specifically to point out
that sometimes IN SPITE of good early management, including keeping
colostrum drained (with pump or otherwise), some women have engorgement
patterns that surge to very dramatic levels and stay there a while.
Hill and Humenick identified 4 common patterns of engorgement in their
normative study: 1. low level (moms have very mild, briefly noted breast
changes), 2. moms who have a spike of considerable engorgement for a day or
so but calm down from then on, 3. moms who report multiple spikes of
engorgement, and 4. moms who come on at high levels of engorgement and stay
there for 12-14 days. So the pattern of engorgment may have individual
hormonal control mechanisms going on in individual women which exist APART
from the management issues (altho they probably interact). So I don't think
we can guarantee that early management per se will prevent engorgement.
Having worked with my fair share of super-producers, I can tell you that
isn't true from my exper. I have one now, on her 3rd baby, that we just put
on estrogen containing bc pills to try to calm her down. She's about to
lose the lactation due to 5th case of mastitis in 3 months. She is the
person with the double abscess seen in The Breastfeeding Atlas. That was
her first child, and she has stumped the best efforts by me, her OB and the
best breast surgeon I know, all of whom have tried to help her manage her
over-supply with baby #2 and even worse now with #3. Yes, we've tried sage
and cabbage. Both foods, so I wasn't too scared we'd make her sicker :)
So no doubt the management also plays a role, as does the interaction with
the baby, including amount of skin-to-skin as per P. Meier's work, but we
don't know that much yet about engorgement. I think that is amazing given
what a ubiquitous experience it is. It could stand a whole lot more
scrutiny, and my comment was mostly just a tickle to get people questioning
assumptions.
Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com
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Date: Sat, 18 Mar 2000 19:56:38 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: Sharing Pumps
Comments: cc: [log in to unmask]
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It is not necessarily true that just because there is mold in the tubing that
you can then draw the conclusion that milk has been backing up into the pump.
Even moisture on the pump parts left after washing and rinsing can back up
into the tubing and cause mold growth. This seems to happen on occasion with
the Pump In Style. I have not seen it with Lactinas. For this reason, I
recommend people make sure their parts are dry when they attach them to the
tubing. It can also help to allow the pump to run for a few minutes after
pumping to dry the tubing.
With the Pump In Style, even if milk did back up into the pump mechanism, the
only way bacteria from the pump could get back into the bottle would be the
following scenario: milk would have to again overflow into the tubing; then
it would have to "mix" with the bacteria in the pump; and finally, it would
have to flow back into the bottle. Seems very unlikely to me. If a mother
fell asleep pumping and if she had a huge milk supply, then it might be
likely. All she would have to do, though, is throw that bottle of milk away
and wash or change the tubing. From a legal standpoint, if people were
sharing pumps and there was a question as to illness related to this, all one
would have to do in a court of law is show that there is a possibility of
this happening. From a practical standpoint, though, it would be very
unlikely.
Cher Sealy, RN, BSN, IBCLC
The Breastfeeding Encounter
Montgomery, Alabama
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Date: Sat, 18 Mar 2000 20:19:58 EST
Reply-To: Lactation Information and Discussion
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From: Alice Ernest <[log in to unmask]>
Subject: Formula recall
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Sat. March 18th, Greenville News. N*s*le recalls 2.5 million cans of baby
formula because they might not have been properly sterlized. Recalled are
Carnation products G**d St**t, follow-Up and Al**y, sold between 10-18-99 and
Monday. Consumers can call 1-800-510-7493 to see if they have purchased any
of the recalled cans. They can be "returned to the store where they were
purchased for a refund or exchange", Who in the world still has cans from 5
months ago and why was this article tucked away on page 2 of the newspaper?
Should be page 1 headlines IMHO.
The article goes on to say that "no illness have been reported". Could it be
that noone was aware? Inquiring minds want to know.
Alice Ernest IBCLC
Simpsonville, SC
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Date: Sat, 18 Mar 2000 20:24:37 -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: NESTLE FORMULA RECALL
Nestle Recalls Certain Cans of Infant Formula Concentrate
Glendale, CA (SafetyAlerts) - Nestle is voluntarily recalling 33 batches of
Nestle's Carnation Good Start, Nestle Carnation Alsoy and Carnation
Follow-Up Infant Formulas, in 13-fluid-ounce concentrate cans, because the
processing may not have reached high enough temperatures to ensure
sterility.
According to Nestle, extensive testing has been conducted and they have
confirmed that there is no healthrisk associated with these batches. Nestle
is recalling these batches as a precautionary measure.
This recall affects only the 13-fluid-ounce concentrate formulas that have
been distributed nationwide. This recall does not affect the powder or
ready-to-drink forms of Nestle Carnation Infant Formulas.
According to a press release issued by Nestle, the following batch numbers
(located below the "BEST IF USED BY" date on the top of the can) are
affected:
Alsoy Concentrate:
9337EWAC3876 and 9338EWAC3876
Follow-Up Concentrate - batch numbers that have on of the folloing as the
last 4 digits in the code:
3785, 3791, 3907 and 3909
Good Start Concentrate - batch numbers that have on of the folloing as the
last 4 digits in the code:
3749, 3750, 3752, 3753, 3754, 3755, 3756, 3757, 3758, 3759, 3759, 3777,
3778, 3779, 3780, 3781, 3782, 3783, 3784, 3827, 3829, 3830, 3897, 3011,
3012, 3013, 3030, 3031 and 3032,
Nestle apologizes for any inconvenience this may cause consumers, and the
company has taken action to ensure this does not happen again.
Consumers can call Nesltes toll-free at 1-800-510-7493 with any questions
regarding this recall.
Cindy Curtis,RN,IBCLC
mailto:[log in to unmask]
http://www.erols.com/cindyrn
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Date: Sat, 18 Mar 2000 20:32:16 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Alice Ernest <[log in to unmask]>
Subject: Sibling class teaching bottlefeeding
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In the March 17th Greenville news, Lifestyle Section, there was an
article picked up from Scipps-Howard, written by Stasia Scarborough regarding
a sibling preparation class at Mercy Medical Center, near Anderson and
Redding California.
The siblings are taught how to help with things like diaper changes and
"feeding". There is a large picture of a 5 year old feeding her "baby" with
a bottle. Apparently, all of the siblings are taught bottlefeeding. Anyone
on the list from Mercy Medical Center who could have some influence on the
"normal" way to feed a baby? I am writing a letter to the editor of our
paper.
Alice Ernest IBCLC
Simpsonville, SC
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Date: Sat, 18 Mar 2000 20:37:28 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Alice Ernest <[log in to unmask]>
Subject: Re: Pump Sharing
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I was told by Medela that the black mold spots in the tubing can come
from moisture getting in the tubing, especially here in the South, and they
suggested putting a few drops of alcohol into the tubing from time to time to
prevent this. Just my .02--don't know if this means anything or not.
Alice Ernest IBCLC
Simpsonville, SC
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Date: Sat, 18 Mar 2000 20:49:21 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: Re: Pump sharing
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Carol:
rental and hospital pumps ( actually one in the same)
are constructed diffferently and if there is a suspicion of milk back-up into
the motor than the pump most certianly must go back to the manufacturer for a
thorough clearing.
<< According to Medela, if it gets into the motor, bacteria can form and can
be reintroduced into the freshly expressed milk. Unfortunately, there is no
way to sterilize this >>
so why don't we have disposable "hospital grade" pumps? >>
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Date: Sat, 18 Mar 2000 21:34:58 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Alice Ernest <[log in to unmask]>
Subject: Carpal tunnel syndrome-herbs & breastfeeding
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Mom breastfeeding a 2 year old has developed carpal tunnel syndrome.
Someone has suggested using Ginkgo, but her family doctor is unsure about
this and breastfeeding. Any herbalists out there that could respond? Email
me privately.
Mom is taking B-vitamins. TIA
Alice Ernest IBCLC
Simpsonville, SC
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Date: Sun, 19 Mar 2000 12:56:23 +1000
Reply-To: Lactation Information and Discussion
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From: Virginia G Thorley <[log in to unmask]>
Subject: Nailbed fungal infections
Comments: To: Diane Wiessinger <[log in to unmask]>
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Hello Diane,
Before the days of the -azole family of anti-fungal =
pharmaceuticals, long-established fungal infections were hard to treat =
and were also often not identified. Common fungal infections such as =
oral thrush were fairly well recognised and treated with gentian violet. =
(I can remember as a very young child having my mouth painted - and =
being disappointed when I found that "painting" my mouth didn't mean my =
mother was doing a work of art there!)
However, nailbed infections were often a source of distress and =
puzzlement to the sufferers. In the 1950s in my hometown, some women =
had fingernails which were growing in a ridged manner, the worst cases =
having the nails come through in thickened lumps, a bit like a glob of =
Araldite glue. Locally the cause wasn't recognised, and was attributed =
to a harsh brand of laundry powder ("Persil fingernails"). My mother =
had the worst case I've even seen, and as she was fastidious, she must =
have felt distress at how her hands looked. The harsh washing powder =
may have provided the port of entry, as wearing rubber gloves in the =
laundry and using a milder soap powder seemed to prevent worsening and =
may have brought a slight imporvement.
So, what worked in the 1950s? Someone suggested bathing the =
fingers in a really hot solution of magnesium sulphate (Epsom salts). =
It may have helped with the less affected fingers - I have the =
impression that it did. Then a woman from another part of the country =
moved next door and became firm friends with my mother. She had seen =
this sort of nail problem before and recommended a tried-and-true =
treatment used among women in her home state - promanganated potash =
(pot. mang.) or Condes Crystals, diluted to the right shade of brown. =
My mother steeped her fingers and nails in this for some time. This =
time, the treatment was noticeably effective. All the affected =
fingernails, except the two worst ones, grew out and were replaced by =
completely normal growth. The family medico later pulled out the two =
really bad nails (ouch!) - and they regrew as beautiful, normal nails. =
No doubt the treatment had already killed the infection in the nailbeds =
of these as well.
If you are going to use gentian violet for the nailbed infections, =
why not try just painting on one site, and soaking (a more dilute, warm =
solution?) the other, just for your own curiosity?
Virginia =20
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Date: Sat, 18 Mar 2000 22:03:36 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Pumping vs expressing
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Chris wrote, and I couldn't agree more, that << Few people here know how to
teach manual expression even though Marmet's Technique is effective and
available on LLLI tear-off sheets. >>
Yes -- this is true even though (to give them great credit) Medela includes a
description of the Marmet technique in the brochure that comes with the
Lactina pump! That's where I originally learned it, and I have taught it to
lots of amazed mothers who can't believe they've never heard of this before...
Elisheva Urbas
neither a rental station nor an LC of any stripe, but a friendly bf busybody
in NYC
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Date: Sat, 18 Mar 2000 22:53:36 -0500
Reply-To: Lactation Information and Discussion
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From: Rene Fisher <[log in to unmask]>
Subject: JCAHO's comming
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Hi everyone,
Next week JACHO is comming to our hospital. At first I wasn't =
nervous but as the time draws closer I'm getting a little nervous. I =
started working about 6 months ago, I had never heard of JCAHO until =
orientation (I'm not an RN). Any words to the wise out there. I've =
looked in the archives but I must have missed some posts, there's one =
asking for help and then a thank you after she received info but I =
somehow missed some answers! =20
I've been told "there definatly going to want to talk to you" but =
that's about all anyone has told me! Besides be confident and tell them =
how wonderful a job you do. But what else do they want to hear, I find =
it hard to believe they only want to know if I'm wonderful or not! I am =
comming off of nomail, I miss LACTNET and I need to hear everyone so I =
dont feel alone out here! =20
Thanks,
Rene R. Fisher BA, LLL, IBCLC
Middletown, NY
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Date: Sat, 18 Mar 2000 23:21:06 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Kermaline J Cotterman <[log in to unmask]>
Subject: milk "blisters"
Comments: To: [log in to unmask]
Bettina, You wrote:
<Through the pregnancy she has developed about 12 milk blisters (or so
they appear) that are not painful and are clustered on
each of her nipples. After a hot shower she can pick them off, but they
recur. She has no breast tenderness or lumpiness and has not noticed
leaking. When she tried to hand express they came out a bit and
probably could have been plucked off like little plugs. Anyone seen
this?>
Have you yourself inspected the nipples, or is this choice of words the
mother's description? I have pictures of a mom who by 28 weeks gestation,
when we did a routine nipple assessment, had a buildup of little,
somewhat shiny mounds of keratin just on the face of the nipple in a
circle area about 3/8 " in diameter. She had not "picked" them off per
se.
But to avoid any adverse reactions on the part of hospital personnel when
it was time to put the baby to breast, we had her soak them at bath time
and remove some of the waterlogged material with a q-tip for microscopic
identification by a pathologist. We had her gently towel the nipples just
as she would her back or other body area, and put a lanolin preparation
on after each bath, and within a month, they were all cleared away.
Some references say that the nipple pores before delivery are occluded
with a mixture of sloughed off epithelial cells and dried colostrum,
which eventually gets moistened and goes into baby as part of early
feedings.
I would recommend that whatever the nature of this, that she be
discouraged from picking them off for fear of damaging the skin barrier
and risking introduction of germs capable of producing mastitis. I have
seen mastitis occur during pregnancy.
Jean
**********************************************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA
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Date: Sat, 18 Mar 2000 23:21:06 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Kermaline J Cotterman <[log in to unmask]>
Subject: Spherocytosis/lactogenesis
Comments: To: [log in to unmask]
Bettina,
Years ago when I worked with our local childbirth education association,
one of the active members was a woman who had spherocytosis. She and all
4 of her sons had had spleenectomies, and she had had unremarkable
childbirth and breastfeeding experiences. It does not make sense to me
that this could be a direct cause of anyone not initiating a milk supply.
I think you are on to something when you say:
<She is convinced that her =
spherocytosis is the reason for her suppressed lactation.. . . . .
. . . . Having something other than herself to blame is =
helping her process alot of angry energy.>
Does she really want to breastfeed, or does she only wish that she could
want to, in order to reinforce her delay in moving out of the victim role
on into being a survivor?
Perhaps the "blame" lies elsewhere. Are her milk sinuses palpable, or are
they located 2" or more deep behind the nipple? Much of the nerve
ennervation responsible for stimulating oxytocin and prolactin release
seems to be in the walls of the milk sinuses. If the baby's mouth is not
yet large enough to reach them with vigor, this might result in less than
ideal prolactin surges and MERs, as well as inefficient milk removal.
If the milk sinuses are deeper than 1-1 1/2 inches, a larger pump flange
may compress them more effectively to speed the process of stimulating
prolactin surges. Would she consider using a hospital grade double
electric pump if possible 4-6 or more times a day for a week or so in
addition to breastfeeding to see if that would change the situation?
Without the main stimulus of consistent, continued efficient milk
removal, I doubt galactagogues will help much
I heard today of a mother with an established milk supply but with deep
sinuses and poor yield with a double pump. She obtained just one large
flange and also used one regular. She alternated which breast she used
the large flange on and was soon consistently getting 4 ounces from the
side where she was using the large flange and 1 ounce on whichever side
she was using the regular size.
Just my suggestion. Good luck. I think this mother is in special need of
some good vibes from her body to help her move this other experience into
her long-term memory and move on with her mothering, and help her
children adjust to their heredity by example.
Thank heaven she lives in a century and a nation where spherocytosis can
be diagnosed promptly and surgery safely performed to help people survive
and live a normal life. I hope she can be helped to adjust to "an
attitude of gratitude"!
Jean
********************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA
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Date: Sat, 18 Mar 2000 20:20:16 -0800
Reply-To: Lactation Information and Discussion
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From: Janie Ginder <[log in to unmask]>
Subject: "normal"
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"This makes me wonder: are there any studies done on healthy newborns in a
non-medicated, non-hospital setting. I wonder if any of us really *knows* what
normal sleeping-feeding behaviour is of newborns in a *natural* setting,
(meaning non-medicated birth in a non-hospital/institional setting), whit mom
and baby not separated and both healthy. And what effect on short and long term
milksupply this sleeping-feeding behaviour has. Does anyone out there know?"
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
In our birthing center moms receive no medication and are instructed to feed baby on cue, they remain at the center for 4-12 hours before going home. We see them at a home visit between 48 and 72 hours. My belief is that while we adults
have our cultural biases, babies have not yet been exposed to any particular culture and can therefore be trusted to abide by the biological norm. (Since we are determining what we believe to be feeding cues we are not completely free from
bias.)
I notice that most babies will show feeding cues at about 20 minutes of age and will continue to feed until they reach two hours of age, they then fall asleep. Most will then show feeding cues and be fed every 1-3 hours round the clock
with one 3-5 hour sleep stretch each day until the milk comes in. There are some babies who are reported to nurse "constantly" until the milk is in but on further questioning it is usually hourly feeds which last up to 40 minutes.
In the past four years I can remember 4 exceptions to this; one was a Down's baby, one showed no interest in feeding for eight hours when he coughed up an extraordinary amount of mucous and then promptly fed, the other two were babes who
tried valiantly but mom's breasts were so tight that they could not latch on for anything, one of these went on to feed well with lots of support, the other mother chose to bottle feed.
I have not seen a single case of obstructive engorgement. Most moms are full and uncomfortable for 24 hours but I would not call this engorgement. Maybe it is just a difference in definition. I have rarely had moms complain of
engorgement. When I was a WIC peer counselor 11 years ago it seemed that everyone got engorged!
I also would like to know what normal is, I think we are pretty close but so much of what our clients do is based on what we teach them that it really hard to be sure we aren't interfering with the process.
Can anyone in a home birthing practice compare this with what they are seeing in the first three days?
Continually Curious,
Janie Ginder RN IBCLC
Eugene, OR USA
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Date: Sat, 18 Mar 2000 23:20:32 -0500
Reply-To: Lactation Information and Discussion
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From: Dianne Veatch <[log in to unmask]>
Subject: Engorgement and feeding intervals
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I tend to see more engorgement in Mom/s who have epidural's, probably =
due to domino effect; IV fluids over a short period of time, sleepy, =
lethargic baby who does not wake to nurse very often. So many of the =
Mom's have areolar edema for at least a day.
Those of you who work in hospitals- does your policy actual state that =
if babies nuzzle, lick, and are skin to skin, you do not have to =
document an actual # of minutes for a feeding? Is it acceptable to chart =
only one feeding in 24 hours? Do they check blood sugars? I have worked =
for years to get our policy changed. Right now the Pediatricians have =
been willing to "let a baby go"without nursing for 5 hours, then check =
the blood sugar and if it is above 40 (recently changed back from 50) =
they can go another hour, then if no feeding after that, formula or =
pumped milk needs to be given, at least 15 cc's. Would appreciate some =
ideas on how to get hospital staff, and physicians to relax about not =
pushing feeding in the first 24 hours.=20
Dianne=20
RN FACCE IBCLC
Florida
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Date: Sat, 18 Mar 2000 20:32:22 -0800
Reply-To: Lactation Information and Discussion
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: What do you know?
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'Thought you'd all like to know that today's National Public Radio's WHAT DO
YOU KNOW? hosted by Michael Feldman had a quiz question asking "what percent
of corporations have lactation programs?" There was a bit of discussion,
some joking, and then the answer...6% Good for Feldman to have included
the question.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Sat, 18 Mar 2000 23:47:06 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: LC in Allentown, Pa
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I am working with a Mother that is wanting to induce lactation for baby she
is adopting. She lives in Allentown, Pa. Hoping to find lactation
consultant to help her out.
Thanks!
Debby Menders RNC
Charleston, WV
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Date: Sun, 19 Mar 2000 00:42:13 EST
Reply-To: Lactation Information and Discussion
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From: Carol Brussel <[log in to unmask]>
Subject: formula recall
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i give all my patients a handout about bottle and formula feeding. just
because they aren't using formula or bottles today doesn't mean things won't
change, some have already been using them before i see them, and i think that
they really need to know. the first item on the list is:
1) Record the lot numbers of all formula you use (found on the can or label)
for reference when formula is recalled. This information is particularly
crucial if your child becomes ill. Any illness in a formula-fed child should
be evaluated including a consideration of a formula-caused problem.
the parents who truly understand the risks of formula feeding will do
everything in their power to avoid it, and those who accept it probably don't
"get it" about this warning, but at least they can't say i didn't tell 'em.
also, since "most" people accept a high level of illness in infants, much of
which is caused by artificial foods, OF COURSE no one is going to blame the
formula.
carol brussel IBCLC
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Date: Sun, 19 Mar 2000 00:59:59 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Kermaline J Cotterman <[log in to unmask]>
Subject: Early feeding
Comments: To: [log in to unmask]
Jean Ridler writes:
<This thread has taken a couple of interesting turns. When to intervene
when
a healthy newborn is not nursing?
One study that I found interesting by Yamauchi and Yamanouchi (1990)
showed that healthy, full-term breastfeeding babies fed:
4.3 times in the first 24 hours (range 0 - 11)
7.4 times in the next 24 hours (range 1 - 22)
(Sorry, I can't find the full reference at the moment - the above I got
from
an OH transparency I made a while back.)
Riodan and Auerbach (p283-284) refers to the first day sleep patterns of
neonates born in hospital and this seem to correlate well with the above
study.
Especially if the baby has fed at least once, preferably in the hour
or so after birth, I don't see any reason to panic until the second day.>
In retrospect, maybe some things weren't as bad after all back in the
1940's and '50's - the baby boom days of babies being NPO for 12 hours,
given 5% GW every four hours for the second 12 hours to stimulate passage
of meconium, and then started at breast (or on formula if not
breastfeeding) at 24 hours.
Although I was not one of them with my first 3 children, there were some
women who made a go of breastfeeding, despite twilight sleep, general
anesthetics and 3-5 minute feedings on one side every four hours, moving
up to 10 minutes every four hours by day 4! But the large number of baby
boomers still around indicates that delayed feeding may not have been
quite so harmful as the swinging pendulum of clinical practice might lead
us to believe!
Jean
*******************************************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA
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Date: Sun, 19 Mar 2000 00:59:59 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Kermaline J Cotterman <[log in to unmask]>
Subject: engorgement
Comments: To: [log in to unmask]
Comments: cc: [log in to unmask]
Denise writes:
< The women whose
babies are sleepy and breastfeed 4 to 5 hourly in those first few days do
experience significantly more engorgement than the ones whose babies are
on
and off the breast all day and all night.
I know there are exceptions to every rule - and yes I agree that some
women
(but a minority) will get engorged, and possibly quite severly so,
despite
the very best of management. But I do suggest that these women are
exceptions.
What has others experiences been?>
There was an Israeli study published in the early 1970's describing the
use of an electric breast pump to induce labor in grand multiparae whose
uteri were more sensitive to oxytocin. From memory, I believe it stated
that besides a gradual, gentle induction of labor, a side effect
mentioned was that these mothers experienced an earlier onset of a
copious milk supply without significant engorgement.
In a number of mothers over a 30 year period whom I have advised using a
breast pump in the last trimester to help develop protractility in
inverted or severely retracting nipples, I have often noted what seemed
like an earlier onset of copious milk production. (No colostrum was
removed with the system I used, and I am now waiting till 37 weeks for
medicolegal reasons)
My eldest and youngest daughters had their first babies 8 years apart.
Each went 3-4 weeks overdue when I let them read the article and obtained
a pump and let them make their own decision about trying to induce their
labor that way. Each one did stimulate contractions, but each ultimately
had a C/S for cephalopelvic disproportion.
Even though I was close by and on hand to assist each one during the
postpartum period, I do not remember any particular problems with
engorgement, despite the fact that each had had IV pitocin augmentation
for a number of hours.
Familiarity with the use of the pump was a dividend to the younger
daughter. She had not really intended to breastfeed, but was gentled into
"at least trying for a week or so" by my dear friend (Hi, Geneva) who
rented electric pumps.
At 12 hous of age, her baby was transferred to a Level 3 hospital when he
required bilateral thoracenteses for collapsed lungs. Between me and my
nurse friends on the OB unit where I had previously worked, she received
a consistent message that her milk would be especially helpful in view of
the baby's respiratory illness.
She began to pump regularly, and when I came back in to visit on the
third day, she handed me 4 full volufeeds she had on ice at her bedside
and asked me if I thought it would be enough for him.
She had her staples removed on the fourth day and we went immediately to
the Children's hospital, where the baby's tubes had been removed and his
IV d'cd. They spent the day in a recliner rocker in a small private room
off of the NICU, getting acquainted and nursing ad lib. Again, I do not
remember observing any significant engorgement.
Considering the high rate of induction these days, I am wondering whether
breast pumps might be incorporated into the induction protocol somehow,
if for nothing but to produce this positive side effect on lactogenesis.
It's the LEAST they could do to offset the effect of the multiple IV's
and/or IV pitocin that seem to add so much edema to the postpartum
period, in the breast area included.
Jean
***************************************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA
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Date: Sun, 19 Mar 2000 03:06:29 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: "Jeanette F. Panchula" <[log in to unmask]>
Subject: drains in breasts after abcess
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I have little experience with this so i'm speaking from working with othe=
r
surgeries which required drains. Both my mother and mother in law had
breast cancer and had drains for a while after surgery. I understood thi=
s
was to avoid the skin closing up too soon and the lymph fluid which came =
to
the area due to the surgery would collect, causing pressure and pain,
possibly abcess. As soon as the drains were collecting below a certain
amount, they were removed, the skin healed and they had no excessive
swelling.
Then my father in law had heart bypass surgery - I went to care for him
after his discharge, and found they had removed the drains in what seemed=
to me a very fast time, on discharge rather than sending him home with on=
e
and letting me monitor it as I had with the other two... I did not pre=
ss
the issue as I arrived after it had been removed - big mistake - 3 months=
later he had surgery for what he was told was probably lung cancer - only=
to find that it was a large amount of blood/serous drainage that had
colllected then formed a capsule.
I realize that both these surgeries are different from an abcess, I have=
read in other Lactnets that these often drain a lot longer than many MDs
feel comfortable with - but that the real experts (MDs and LCs who are us=
ed
to working with breasts that are lactating) say "it's a laundry problem a=
nd
will heal"...
Jeanette Panchula, BSW, RN, IBCLC
Vacaville, CA
mailto:[log in to unmask]
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Date: Sun, 19 Mar 2000 09:17:52 -0000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Magda Sachs <[log in to unmask]>
Subject: my comments on the professor
Comments: cc: [log in to unmask]
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Chris, you said: I have to say that the assumption was that
because I was there as a research academic (they didn't realize that I had a
private practice), that my head was in the sand (or somewhere even darker).
I should just say that Dr Davies, whom I was quoting, makes clear that he
does have or has had quite a lot of clinical pratice (the voices of women
come from this). In the UK only the head of department is usually a
professor, so there are a lot less of them around than in the US. I didn't
mean to impune the academic research community!! In fact, I think it is the
idea of Davies, the practitioner as consultant paediatrican who radically
critiques regular weighing of babies in community clinics in the UK who is
most interesting and exciting.
Magda Sachs
Breastfeeding Supporter, BfN, UK
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Date: Sun, 19 Mar 2000 05:41:48 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Valerie W. McClain, IBCLC" <[log in to unmask]>
Subject: gentian violet uses
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Dianne, Gentian violet works for ringworm-a fungal infection. My kids would
get this infection after playing in some swampy areas(Florida) or so it
seemed. First time it happened I did the over-the-counter stuff and then
prescription stuff, nothing worked. I called a midwife and she told me
gentian violet. Sure enough it clears up in about 24-48 hours with gentian
violet. Valerie W. McClain, IBCLC
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Date: Sun, 19 Mar 2000 09:56:18 +0000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: heather <[log in to unmask]>
Subject: Re: 6 hour pump reference
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>snip
>> One study that I found interesting by Yamauchi and Yamanouchi (1990)
>> showed that healthy, full-term breastfeeding babies fed:
>> 4.3 times in the first 24 hours (range 0 - 11)
>> 7.4 times in the next 24 hours (range 1 - 22)
>snip
>> Riodan and Auerbach (p283-284) refers to the first day sleep patterns of
>> neonates born in hospital and this seem to correlate well with the above
>> study.
>snip
>
>This makes me wonder: are there any studies done on healthy newborns in a
>non-medicated, non-hospital setting.
Gonneke, my feelings exactly.
> I wonder if any of us really *knows* what
>normal sleeping-feeding behaviour is of newborns in a *natural* setting,
>(meaning non-medicated birth in a non-hospital/institional setting), whit mom
>and baby not separated and both healthy.
Yes - I would need to know if Y&Y's babies were with their mothers.....and
not only that, what constitutes the baby 'feeding'. A little lick, a small
suck without a swallow, a lot of small sucks with fewer swallows? Or a
timed 'session' at the breast which we might (subjectively) call a 'good
feed'....there is a huge range of physiologically normal behaviours and
acts that could be described here.
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
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Date: Sun, 19 Mar 2000 10:25:44 +0000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: heather <[log in to unmask]>
Subject: Re: routine growth monitoring
In-Reply-To: <000b01bf9120$5976c480$3a5008c3@sachs-davis>
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Magda draws attention to :
>The 1999 update of the Cochrane trial is now transmogrified into an article
>in the March issue of the Archives of Disease in Childhood (the journal of
>the Royal College of Pediatrics and Child Health): Is routine growth
>monitoring effective? A systematic review of trials. Garner, P,
>Panpanich, R Logan, S ADC 2000 82 197-201
This is really hot stuff, and it is so challenging, I worry that it will
disappear. The Prof is questioning something so routine, so taken for
granted, so much a part of life like eating and breathing, that it will be
largely ignored, even as a topic for discussion within his own
journal....as he suspects, the idea of a trial might not even get past
Ethics Committees.
>
>In addition to the article is a Commentary by Prof DP Davies, who has won
>his way into my heart with his words: "I wonder whether the measurement of
>weight...should be an investigation of possible abnormality rather than a
>routinely carried out primary clinical measurement as -- for example, the
>measurement of haemoglobin where anaemia is clinically suspected?
Not that great an analogy, though.....pregnant women get their haemoglobin
levels checked routinely, and I know in the US, babies get their iron
levels checked routinely (not done here, unless there are clinical
indications, or a toddler is on a very restricted diet).
>"Comments over many years from mothers who have derived little satisfaction
>from regular weighing, and who have sometimes suffered unneccessary worry
>support my anxieties.
Yes - he's actually listening to mothers. What a great guy!
The slight problem is - and I have often said this - that dispensing with
weighing is risky, unless mothers and their care providers have other ways
of knowing everything's ok. This doesn't have to be rigid counting of
nappies, or ticking boxes on charts, or timing or counting feeds....it's
more a question of observing baby behaviour and being responsive to it.
In a culture which finds it very, very difficult to feed ad lib, and where
mothers are encouraged not just by too many HPs but also by every possible
social pressure to get the baby into a routine, to limit feeds, to not
'spoil' the baby, routine weighing can possibly provide a safety net.
Babies who feed infrequently and who sleep a lot are thought to be 'good'.
If those babies aren't weighed, they could fall through the net. I have
come across a few situations where it was *only* the weight that alerted
mother and HP to a potentially dangerous situation.
I get too many calls from mothers who feel *bad* about just feeding their
babies when they or their babies want to. Like the call I had the other day
from a mother of a 2-week-old who was miserable unless near or on the
breast.....'but I don't want to be picking him up when he cries - he'll
just get used to it.'
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
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Date: Sun, 19 Mar 2000 11:09:34 -0000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Magda Sachs <[log in to unmask]>
Subject: routine weight monitoring
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Heather, you said: routine weighing can possibly provide a safety net.
Babies who feed infrequently and who sleep a lot are thought to be 'good'.
If those babies aren't weighed, they could fall through the net. I have
come across a few situations where it was *only* the weight that alerted
mother and HP to a potentially dangerous situation.
I agree with you, actually in theory. Weighing actually opens the gateway
to some clinical examination of the baby and a focus on on-going
development. However, there is also a literature which shows that not only
is the practice of weighing (calibration of scales, undressing of babies,
time of day, accuracy of recording, continuity of weigher/scale) often poor,
but the ability of professionals working in the field to accurately
understand, interpret and appropriately intervene or refer is also not
stunningly reassuring.
Having started looking into this field with great scepticism on the value of
weighing I am beginning to see some benefits, but I think these are usually
overwhelmed by a) poor practice and b) unintelligent and slavish use of
weighing as blanket proceedure. Question is -- having got ourselves into
this pickle, how to retrieve something from it?
Magda Sachs
Breastfeeding Supporter, BfN, UK
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Date: Sun, 19 Mar 2000 06:34:15 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Patrica Young <[log in to unmask]>
Subject: Advisor Forum Question-long
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I read a magazine for NPs called "The Clinical Advisor for Nurse
Practitioners". e-mail address <[log in to unmask]> They have a Q this
mo (March 2000) that I thought may be answered by someone in our collective
1600+ membership. Please answer them directly and cc to Lactnet. I'm
typing in their Q & A and my answer.
Lacation Issues in Peripartum Cardiomyopathy
Q.
Although peripartum cardiomyopathy is a rather unusual condition, Colleen
Balch, NP, Clay NY, recently has cared for a young woman with this
diagnosis. "I find scarce information to guide me on lactation issues.
One must worry about drugs crossing into the milk as well as increased
fluid intake needs for breast-feeding in patients with congestive heart
failure. I wonder what experiences others have had with such patients."
A.
Peripartum cardiomyopathy affects an estimated 250-1350 women in the United
States per year. It is a type of dilated cardiomyopathy causing symptoms
typical of heart fatigue: fatigue, shortness of breath, chest pain, and
edema. It can occur late in pregnancy and after delivery. Patients with
this condition are often treated with medications to improve cardiac
function and alleviate symptoms, e.g., digoxin, alpha and beta blockers (Am
J Obstet Gynecol 178:409, 1998). You are correct in that there is limited
literature on issues of lactation and medications used in peripartum
cardiomyopathy.
The patient's condition dictates whether she can breast-feed, considering
that breast-feeding can increase demands on the heart. If a woman chooses
to breast-feed, the risks and benefits, especially in light of medication
use, need to be discussed with her. Other readers who've had experience
with this condition should write to the Clinical Advisor to share their
findings. - AL (23-30)
My answer:
Dear Clinical Advisor, AL and Ms. Balch,
Any HCP who sees mothers or babies on a regular basis needs to own a
current copy of "Medications and Mothers' Milk", by Thomas Hale, Ph.D. My
current copy is the 8th ed., 1999-2000. It is available from: Pharmasoft
Medical Publishing, 21 Tascocita Circle, Amarillo TX 79124-7301.
<www.perinatalpub.com> Dr. Hale has also written a new book called
"Clinical Therapy in Breastfeeding Patients", 1st. ed., 1999.
Both books are modest in price and extremely valuable additions to any
HCP's office and a neccessity on OB & Ped hospital units.
Dr. Hale discusses how drugs enter mother's milk and the properties of the
drugs themselves and how this contributes to the amount in mother's milk.
I have not personally ever had a patient with this problem. However,
mothers can relax and lie down to nurse. In fact, stopping periodically
during the day and nursing in bed at night give mom extra rest that she
wouldn't have if formula feeding. We know that the breastfed infant is a
healthier infant, with less feeding problems and colic than the formula fed
infant. A healthier, happy baby is easier to care for than one who gets
otitis and GI upsets. Breastfeeding has health implications for mother
too. In the long term, breast is best for the health of mother and
baby.
Sincerely, Patricia Young (New Jersey)
RN, MSN, CPNP, IBCLC
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Date: Sun, 19 Mar 2000 12:19:31 +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: catheters and infection
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Annette wrote:
> This child was her first VBAC. She did get an epidural and catheter. 2 days
> ago she started complaining of back pain. Now she has a temp. and was
> admitted back to the hospital. They decided it was a urinary track infection
> of some sort and she is on antibiotics. The nurses were telling her not to
> nurse (because of the fever). I let her know it was O.K. to nurse the baby.
> He is rooming in with her.
>
> I am having her follow an anti-yeast diet while on the antibiotics. She seems
> prone to thrush.
>
> Are there many moms that get infections like this after using catheters?
I don't know that, but I just recently read that Candida loves catheters. So I'd
like to ask if it's certain that it was a bacteriologic urinairy tract
infection or could candida play a role as well?
And I have the ref this time: Hawser SP, Douglas LJ: 'Biofilm formation by
Candida species on the surface of catheter materials in vitro.' Infections &
Immunity 62(3):915-921, 1994.
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
http://www.users.skynet.be/eurolac
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Date: Sun, 19 Mar 2000 06:49:33 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Patrica Young <[log in to unmask]>
Subject: Re: 6 hour pump reference
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The article in question is: "Breast-feeding Frequency During the First 24
Hours After Birth in Full-Term Neonates" by Yamauchi & Yamanouchi,
Pediatrics 86 (2) August 1990, 171-175. This is actually a study about mec
passage and bilirubin levels :-)
Criteria for study: healthy, uncomp. vag del, bf within 4-6 hours of birth,
birth weight >2500 g, gestational age >37 weeks, Apgar sore >7 at one
minute and negative results on direct Coombs' test.
"All neonates remained in their mother's rooms from the time of delivery.
Mothers were encouraged to nurse their babies whenever they suspected they
were hungry and were told not to limit the frequency or length of
nursing."
>From abstract: "The results demonstrate that frequent suckling in the first
days of life has numerous beneficials effects on the breast-fed, full-term
newborn." Duh :-)
Sincerely, Pat in SNJ
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Date: Sun, 19 Mar 2000 07:01:18 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Patrica Young <[log in to unmask]>
Subject: Re: routine weight monitoring
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I'm one of those "slavishly devoted to weights" :-) I use it to back up
my clinical impressions (not the other way around.) I make myself only
look at a baby's own progress, not in comparison to every other baby, but
in comparison to self, upwards, steady etc. From my reading I've also
learned to expect plateaus and dips and understand why. It is really just
one more part of the picture, not THE picture, if you get what I mean.
Baby's weight and progress in this area, according to Hrdy is something
that all parents have always honed in on, as a predictor of baby survival.
I know parents are definetely preoccupied with kids' weight. No one (but
me) seems to worry about overfeeding kids, but let me tell you that all
parents focus on "too skinny", "doesn't eat enough", "small appetite",
"eats NOTHING" ad nauseam every day in the ped office! (and culturally
some parents are worse about it.) And let me assure you that these are all
nice, well developed little kids, doing their own thing.
Sincerely, Pat in SNJ
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Date: Sun, 19 Mar 2000 09:15:32 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: engorgement/C-secs/epidurals
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I tend to see more engorgement in c/s-epidural moms whose physician uses
Reglan as an anti-nausea/anti-emetic prophylaxis. If you see moms in the
community, sometimes they are not aware that they were given Reglan. It has
helped to learn which docs use this protocol and be ready to jump in on day
two with these patients. Remember, too, that women who have had c/s may not
want to feed the baby as often as the baby is hungry due to their discomfort.
Many of them are not aware of the football hold or opportunity to take pain
meds prior to a feed. This seems so basic to us, but sometimes the nurses are
"amazed" at these good ideas. I also tend to see many younger women who may
be slightly exagerating their discomfort for attention....I know it is major
surgery but we can help them help themselves feel better if they are
compliant. ( I really don't like that word but what else have we got?)
Rambling on in Romeoville, IL
Mary Kay Smith, IBCLC
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Date: Sun, 19 Mar 2000 09:34:53 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Cheryl Parrott <[log in to unmask]>
Subject: More on Pump Sharing
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In my limited experience as a rental station, I routinely tell moms that the
Pump in Style is meant to be used by one mom. But then I also know that
Medela sells all the tubing, flanges,etc seperately so when I have a mom who
has borrowed or bought used pumps I can get her all new "stuff" to go with
the PIS. Also, the instructions tell you how to clean the pump mechanism if
milk backs up, not sterile but clean. For women who I know are financially
challenged I keep a private list of those I know willing to sell their used
pumps and refer them to web sites that I know auction or sell used pumps and
then get them all new accessories.
Humbly,
Cheryl Parrott RN, BSN
Kokomo, IN
<<it's raining today YUCK>>
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Date: Sun, 19 Mar 2000 09:40:14 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Re: abscess and hydrogel
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Dear Folks:
Deep wounds need to heal from the inside, or deepest part, to the
outside. If this mother has a deep incision to reach and drain the abscess,
the upper part of the incision has to be kept open so the base will heal.
That is the concept behind packing a wound: to keep the top of the hole open
so the base can fill in.
Surface healing would leave a pocket underneath, which could be a focus
for another infection.
Nutritional supplements would be helpful along with the packing/repacking.
Warmly,
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: Sun, 19 Mar 2000 09:43:40 -0500
Reply-To: Lactation Information and Discussion
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From: Amy Kwilinski <[log in to unmask]>
Subject: gentian violet
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Traditionally it had other antifungal uses. Once I even checked out a
children's book which told about using GV to paint a mother cow's bottom
area after she delivered! It was used for other purposes by MDs
regularly, though now it is not taught at all in Medical school for
treating thrush (according to a friend who recently finished at a
top-ranking program.) This may vary.
But, I found this on Medline:
Dermatology 1999;199(3):231-6
Effect of gentian violet, corticosteroid and tar preparations in
Staphylococcus-aureus-colonized atopic eczema.
It reduced the Staph and was said to demonstrate high antibacterial
efficacy."
Hmmmm...how does this apply for the latest journal club article?
and this:
Am Fam Physician 1996 Oct;54(5):1687-92
Topical antifungal agents: an update.
Diehl KB
Medical Center of Delaware, Wilmington, USA.
So many topical antifungal agents have been introduced that it has
become very difficult to select the proper agent for a given infection.
Nonspecific agents have been available for many years, and they are
still effective in many situations. These agents include Whitfield's
ointment,
Castellani paint, gentian violet, potassium permanganate, undecylenic
acid and selenium sulfide. Specific antifungal agents include, among
others,
the polyenes (nystatin, amphotericin B), the imidazoles (metronidazole,
clotrimazole) and the allylamines (terbinafine, naftifine). Although the
choice of an antifungal agent should be based on an accurate diagnosis,
many clinicians believe that topical miconazole is a relatively
effective
agent for the treatment of most mycotic infections. Terbinafine and
other newer drugs have primary fungicidal effects. Compared with older
antifungal agents, these newer drugs can be used in lower concentrations
and shorter therapeutic courses. Studies are needed to evaluate the
clinical efficacies and cost advantages of both newer and traditional
agents.
BTW, I had trouble sending this, although I have sent in the past...I
think it might be because I can receive with either.com or .net after my
Email address...the server said I was not subscribed although I have
been receiving posts all along!
Amy Kwilinski
LLL Leader, Fort Wayne, IN
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Date: Sun, 19 Mar 2000 07:24:20 -0700
Reply-To: Lactation Information and Discussion
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From: Patricia L Donley <[log in to unmask]>
Subject: Gentian violet on toenails
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What a hoot! Diane, I think you could start a fashion trend! Might as
well paint all your toes purple so they all match! (Seriously, though, I
don't have an answer to your question re: whether or not it will work...)
I'll be interested to hear how your sample size of one (or two, if you
convinced your nephew) fares in this venture. Keep us posted!
Trish Donley RN ND IBCLC
Fort Defiance, AZ
(on the Navajo reservation)
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Date: Sun, 19 Mar 2000 07:53:20 -0700
Reply-To: Lactation Information and Discussion
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From: Patricia L Donley <[log in to unmask]>
Subject: JCAHO
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Rene
From my experience with JCAHO (from the standpoint of a nurse working in
a hospital, not as an IBCLC), they will want to see your protocols, how
you document, and, most recently, are interested in your documentation of
resolution of problem and/or follow-up.
Hope this helps.
Trish Donley RN ND IBCLC
Fort Defiance, AZ
(on the Navajo reservation)
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Date: Sun, 19 Mar 2000 11:13:26 EST
Reply-To: Lactation Information and Discussion
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From: Carol Brussel <[log in to unmask]>
Subject: heart problems
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<< The patient's condition dictates whether she can breast-feed, considering
that breast-feeding can increase demands on the heart >>
yes, it places intolerable demands upon my heart when a baby cannot
breastfeed.
carol brussel IBCLC
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Date: Sun, 19 Mar 2000 12:22:24 +0200
Reply-To: Lactation Information and Discussion
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From: Jean Ridler <[log in to unmask]>
Subject: Re: Pacifiers.
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Hi Barb
> I read somewhere that pacifiers (as well as bottles) can cause otitis
> media. I am aware of two b/f babies, who both have dummies, that have
had
> repeated otitis media and have had grommets put in. What is the
mechanism
> behind the dummy (SA term - Yuck) use and otitis media?
I just happen to have this stuff on my desk! Yes, dummy (pacifier) use is a
significant risk factor for otitis media. Two studies that support this
(one retrospective and one prospective):
Niemela M, Uhari M, Hannulesela A: Pacifiers and dental structure as risk
dactors for otitis media. Int J Peidatr Otoshinolaryngol 1994; 29: 121-127
Niemela M, Uhari M, Mottonen M: A pacifier increases the risk of recurrent
acute otitis media in children in daycare centres. Pediatrics 1995; 96:
884-888
According to two older studies (Bluestone, Wittenborg - refs if you want),
frequent sucking on a dummy could be harmful for the functioning of the
Eustachian tube. The pressure equilibrium between the middle ear and the
nasopharynx, which is maintained by active and passive opening of the
Eustachian tube is important for protecting the middle ear from infection.
This proper funcioning also protects the middle ear from reflux of secretion
from the nasopharynx.
Regards
Jean Ridler RN RM IBCLC
Cape Town, South Africa
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Date: Sun, 19 Mar 2000 11:19:32 EST
Reply-To: Lactation Information and Discussion
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From: Carol Brussel <[log in to unmask]>
Subject: routine weighing
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there are LCs (in my area) who believe it is necessary to do a test weigh
(before and after nursing) of EVERY mom/baby dyad they see. they honestly
can't tell if the baby is transferring milk, or perhaps they believe that
reduced intake is a factor in every single problem they see or i don't know
what, but i have been criticized for believing that test weighing is an
invasive procedure and should be used when needed.
on the plus side, of course, that scale costs a lot, and if you use it every
single time, not only do you look really medical (does that mean the same as
professional?) but you can justify the cost by saying you gotta have it. i
agree you gotta have it. i just try to avoid using it to scare someone when i
don't think it is warranted. who said moms look at the weigh in as an exam
they are afraid they will fail? ever so true.
carol brussel IBCLC
weighs mail all the time on that scale
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Date: Sun, 19 Mar 2000 10:22:53 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: gima <[log in to unmask]>
Subject: Re: gentian violet for digits?
In-Reply-To: <[log in to unmask]>
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At 11:12 AM 3/18/00 -0400, you wrote:
>Does gentian violet work on fungi besides Candida?
Nail fungus does respond to Gentian Violet. I've had several clients (plus
a nephew) who had family members use the GV on their nails after it was so
effective on oral and nipple yeast.
One baby had thrush, very red bottom, and a toenail that was infected. He
was being treated for thrush, but the Ped didn't have a clue what was wrong
with his toenail. He did a culture, and guess what it was... yeast. The
mom painted his nail with GV for about a week, and it cleared up. Ped had
suggested Nystatin, but since it hadn't done anything for the oral yeast,
mom went right to the GV.
Do you remember Carol B's guide to "Lactnuts on the Beach" before Boca
Raton?
8. Lactnuts can be identified by use of gentian violet for finger and toe nail
polish.
So, the precedence has been set.
Go for it!
Oh, a great GV story from another LC.
A mom carefully painted her baby's mouth with GV and he promptly sneezed,
spraying her face, neck and shirt with tiny dots of the glorious purple.
Fortunately, she was able to see the humor in it and called the LC to tell
about it.
By the way, I learned on Lactnet that if one soaks clothing in rubbing
alcohol overnight the purple is removed. I even tried it with my white lab
coat for a good test, and it did come out.
Pat Gima, IBCLC
Milwaukee, Wisconsin
Mailto:[log in to unmask]
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Date: Sun, 19 Mar 2000 11:27:12 EST
Reply-To: Lactation Information and Discussion
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From: Barbara Latterner <[log in to unmask]>
Subject: Fantastic Conference!
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Just finished participation in our consortium's two day, Wolf and Glass
conference and found it to be excellant, both in information imparted and
sharing opportunity interdisciplinarily (is this a word?). They are
wonderful speakers, have fantastic videos and slides, a wealth of experience
with suck/swallow difficulties and relate well to breastfeeding situations.
One example of sharing occured with an OT who asked me why LC 's seemed
against pacifiers as osteopaths who do craniosacral therapy feel pacifiers
help to correct cranial difficulties (because of the sucking)-her experience.
( OT's, Speech Pathologists, Developmental Specialists were there, as well as
about half LC's). I told her how pacifier use can lead to early weaning when
used in place of the breast when baby needs to BF often to increase supply,
for comfort, etc.; how pacifier use can create malocclusion and mentioned
McKenna's studies of co-sleeping and frequent and longer duration BFing would
be preferable and meet the need for increased sucking to help normalize
cranial difficulties. She walked away with an "I see" look and comment and I
hope will pass this info on and use it herself in her practice.
This type of sharing with other disciplines is so exciting as it can have a
ripple effect and may save a breastfeeding relationship in the future.
Barbara Latterner
Brewster,NY (who now feels the hassle of being registrar for this conference
was well worth it!)
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Date: Sun, 19 Mar 2000 11:28:29 EST
Reply-To: Lactation Information and Discussion
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From: Anne Merewood <[log in to unmask]>
Subject: insufficient glandular tissue
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Hi All
I am looking for anything published in academic journals on insufficient
glandular tissue as a reason for lactation failure. As far as I can make out,
there was one paper in Pediatrics in 1985 (Neifert and Seacat) to which both
Ruth Lawrence and the R&A texts refer. I can't find anything else.
Specifically I am trying to help someone with asymmetry. I have heard so much
discussion about this I cannot believe there is nothing much written about
it. Anyone have any other references I am missing?
Thanks Anne Merewood IBCLC
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Date: Sun, 19 Mar 2000 11:32:13 EST
Reply-To: Lactation Information and Discussion
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From: Anne Merewood <[log in to unmask]>
Subject: Baths
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Our hospital is trying to eliminate nursery baths and to perform tub baths in
the mother's room as a final step before we close the nursery down. Those of
you who do TUB BATHS in mom's room - do you buy new bath tubs for each
infant? Do you clean and recycle? Any suggestions welcome....
Anne Merewood IBCLC
Director of Lactation Services
The Breastfeeding Center, Boston Medical Center
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Date: Sun, 19 Mar 2000 09:50:23 -0700
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: jhroibal <[log in to unmask]>
Subject: Dental caries re-post
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I'm posting this info again for the person with questions about dental
caries:-)
There seems to be many conflicting opinions. I've investigated this
issue thoroughly and several things pop into mind that may increase a
child's risk for dental caries.
absence of certain vitamins during mother's pregnancy
certain medications taken during mother's pregnancy
variations in enamel development
an infant's state of prematurity
family history of dental caries
certain strains of highly acid producing bacteria in child's mouth
There is an excellent article written from a pediatric dentist's
perspective in LLLI's NEW BEGINNINGS, Jan-Feb. 1997 pages 10-12.
Lots of treatment options/preventative measures are given, ranging from
suggestions for mothers with a history of extensive dental caries to
avoid sharing spoons with her child because of possible transfer of
"bad" bacteria--to suggestions on how to manage oral flora.
Parents are also urge to brush their child's teeth 3 -4 times aily and
investigate appropriate fluoride options. I highly recommend this
article.
Heidi S. Roibal
where the entire state experienced a black-out for about 3 hours Sat.
night. Thank goodness breastfeeding doesn't require electricity!
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Date: Sun, 19 Mar 2000 16:53:22 +0000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: heather <[log in to unmask]>
Subject: Re: routine weighing
In-Reply-To: <[log in to unmask]>
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Carol says:
>there are LCs (in my area) who believe it is necessary to do a test weigh
>(before and after nursing) of EVERY mom/baby dyad they see.
Really? But what are they looking for? "Adequate" intake in terms of
volume? And how do they define that, knowing (as they must do) that it is
normal for the amount of milk to differ from feed to feed, and for the
calorific value to differ from feed to feed, and knowing (as they must do)
that this baby could wake up in 20 minutes (or less, or more) and have some
more.....
>what, but i have been criticized for believing that test weighing is an
>invasive procedure and should be used when needed.
Of course it is invasive. But test weighing pushes my buttons, so I'm bound
to agree with you, Carol : )
>
>don't think it is warranted. who said moms look at the weigh in as an exam
>they are afraid they will fail? ever so true.
And it's also true that in the UK, where health care at baby clinics is
free, and available as a 'drop in' everywhere but the most rural (and even
in rural areas, there are mobile clinics), and home visits are normal
(though less common these days)...mothers are sometimes too scared to go to
the clinic because they are worried about the weighing (fortunately, test
weighing is almost never done now, except in extreme situations). Mothers
call volunteer counsellors, fretting about an up-coming clinic visit,
because of what the scales will say....only too aware that in the wrong
hands, this may take precedence over any other sign of health, development,
and 'competence' as a mother.
I even felt it myself with my first two - even though I could see my
gorgeous babies were thriving and I knew bf was going well. The anxiety as
they were placed on the scales was acute. My third baby never went to the
clinic at all except for immunisations.
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
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Date: Sun, 19 Mar 2000 12:54:08 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Dave Barry
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Dave Barry's column today is on the difference between the male and female
sense of humor, and includes an example from breastfeeding class about the
cloth breast model ("kind of like a muppet"). My dh and I both LOL while
reading it. <A HREF="http://www.herald.com/archive/barry/">Miami Herald Online
</A> or www.herald.com/archive/barry, click on the headline to read the full
text.
Elaine Ziska
Jackson, MS
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Date: Sun, 19 Mar 2000 13:00:53 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Re: bf law
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Today's ( sunday 3/19) Chicago Tribune has a note on a Spanish law that was
invoked in court to reimburse a gentleman for money docked from his pay for
the time he took off to go home ( 1 hr. a day) to be with his wife and
infant. The law on the books grants breaks to gov. employees with babies 9
months old or less. The court ruled that the law did not distinquish between
male and female emplyees!
Patricia
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Date: Sun, 19 Mar 2000 13:08:18 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: "normal" , engorgement and homebirth, n=1
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In a message dated 3/18/00 11:03:50 PM Central Standard Time,
[log in to unmask] writes:
<< Can anyone in a home birthing practice compare this with what they are
seeing in the first three days? >>
My dd was born at home around 9pm, latched and bf vigorously within ten
minutes, slept with me that night, and my milk surged within 24hrs. I was
very full/engorged but didn't experience it as painful and didn't treat it.
I developed sore, cracked nipples (lazy positioning) by day 3 and then severe
mastitis by day 7. BF was never interrupted and she never lost an ounce.
This time I'll manage the positioning and engorgement more aggressively.
Pamela Morrisson has provided some suggestions, others are welcome.
Elaine Ziska
Jackson, MS
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Date: Sun, 19 Mar 2000 14:13:28 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Sterilizing pumps?
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carol says,
<< i have heard other rental
people say they sterilize the pump and clean it, etc., between rentals (good
idea) but i have also seen moms in the hospital go to the "pumping room" and
sit down and use a pump, and no one is standing at the ready with cleaning
and sterilizing equipment. >>
If any rental people are telling you they are actually sterilizing the pumps,
they aren't telling you the truth, or they haven't a clue as to what
sterilization means. Clean it thoroughly? Yes. Absolutely. Sterilize?
Absolutely not.
One might consider the fact that if mothers are encouraged to share/resell
the $250+ not-quite-hospital-grade-pump, then the pump company and/or the
rental stations would make less money because they would sell fewer of the
machines.
Of course, I'm sure that that particular mercenary thought never ever entered
the corporate minds.
Jan B, slightly cynical in Wheaton.
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Date: Sun, 19 Mar 2000 14:33:13 -0500
Reply-To: Lactation Information and Discussion
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From: Stephen Curless <[log in to unmask]>
Subject: JCOHA
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Rene:
We recently had Joint Comm. visit. They asked questions on
interdisciplinary communication between dietary, social service,
anesthesia, lactation consultants. We have one form for each to sign.
They asked why our refrigerator containing breastmilk was not labeled
biohazard. I had the protocol from Human Milk Bank which explained that
breastmilk is not biohazard. She then asked for a copy of this book and
info was given where she could order. She wanted to know my credentials
for doing my job (I am an RN, and IBCLC). We did fine on evaluation. The
main thing is to have correct, current information, with references to
back you. Don't get too nervous, be confident.
Helen Curless,RN,IBCLC
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Date: Sun, 19 Mar 2000 14:42:38 EST
Reply-To: Lactation Information and Discussion
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From: Ann Perry <[log in to unmask]>
Subject: engorgement
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My observations have been when a woman has had any previous breast surgeries,
such as breast reductions and augmentations, she has marked engorgement
postpartum even with early and frequent feedings.
Has anyone else noted this? The engorgement tends to last 36-48 hours with
vigorous management.
I have a theory that when a breast has had the type of manipulation such as
these surgeries that there is more congestion in the tissues after the shift
the body goes through postpartum.
Would like to hear what others think or know.
Ann Perry RN IBCLC
Boston, Mass
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Date: Sun, 19 Mar 2000 14:56:03 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Patrica Young <[log in to unmask]>
Subject: Re: Dental caries re-post
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Another problem can be a viral illness with high fever when baby is around
6 mo. This can damage the enamel on the teeth buds. Sincerely, Pat in SNJ
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Date: Sun, 19 Mar 2000 15:20:40 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: test weighing
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carol says,
<< there are LCs (in my area) who believe it is necessary to do a test weigh
(before and after nursing) of EVERY mom/baby dyad they see. they honestly
can't tell if the baby is transferring milk, or perhaps they believe that
reduced intake is a factor in every single problem they see or i don't know
what, but i have been criticized for believing that test weighing is an
invasive procedure and should be used when needed. >>
I do an ac/pc weight with almost all of my consults in my private practice,
or those that come to me w/ problems. I never call it a test weigh, and I
always talk about seeing how the baby does, not the mom. Most of my problems
that I see are r/t low or slow weight gain -- plus the sprinkling of thrush
here and there. But I do want to point out that I've been fooled more than
once by "hearing swallows" and SEEING long, drawing, nutritive suckling, only
to have a baby very unhappy at the end of the feed -- and to check the weight
and find out he took a whole lot less than I thought he did. And this
finding does change my recommendations from -- 'oh, he's transferring lots of
milk -- just hear him gulping and look at those long drawing swallows' to one
that might be more interventive if we are on day 7 and baby transfers only 9
or 10 mls and is still losing weight.
In my 15 years of practice w/ a busy pediatric group and a private practice,
I've been fooled by the swallow sounds and nutritive looking suck more times
than I care to think about. So -- perhaps I'm old and don't hear well out of
one eye, and can't see out of the other -- but I do use ac/pc weights when
warranted. Perhaps it's because of the way I word it, but the moms I work
with are happy to do it, and don't view it as a "test" they have to pass.
Jan -- feeling quite scaly at the moment.
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Date: Sun, 19 Mar 2000 15:27:56 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: tub baths?
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Anne asks,
<< tub baths in
the mother's room as a final step before we close the nursery down. Those of
you who do TUB BATHS in mom's room - do you buy new bath tubs for each
infant? Do you clean and recycle? Any suggestions welcome.. >>
Tub baths? As in put the BABY in the tub? Surely you jest! My stars and
garters....this is unamerican! This is heresy!! This is -- umph, hurrumph,
well -- against political correctness. Surely you KNOW that putting a baby
in a tub with WATER before the cord falls off will cause -- ummm -- well, at
the least, cord rot. And probably an infection. And maybe he'll need a
liver transplant. Why, I'm sure there are simply thousands of sound,
reliable studies that have demonstrated that babies who are put in tub baths
before the cord falls off have dropped dead faster than babies who were not
put in tubs -- Leboyer not withstanding. Isn't "not tub bathing" evidence
based research? Hmmmm????
Truly Anne, are you really truly tub bathing babies in your nursery? What a
wonderful departure from TRADITION!! (Hear me sing it loud and clear --
TRADITION!) Would that we could get the rest of the U.S. to do what other
countries have been doing for years....
Is there hope?
But I don't have an answer to your question.
Jan B -- in Wheaton where we have lived with "Fiddler on the Roof" for nigh
unto 6 weeks now, and where the cast got a standing ovation last night!
TRA--DI--TION!!
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Date: Sun, 19 Mar 2000 12:59:42 -0400
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Marilyn Norton <[log in to unmask]>
Subject: Mens Health article
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My husband was very quick to show me this article from the April 2000 issue
of Men's Health.
Breast Men Rule
Three reasons your newborn should breastfeed
..."according to various studies, breastfeeding is better for him than
sucking on infant formula. In fact, the natural stuff may make your kid...
> Leaner
>Smarter
>Healthier
Each of the reasons is supported by scientiic studies. There is even a very
tasteful picture of a baby latched onto a breast. Note- some people may
find some of the wording a little crude.
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Date: Sun, 19 Mar 2000 21:52:34 +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: routine weighing
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fretting about an up-coming clinic visit,
> because of what the scales will say....
Sounds like a Weight Watchers meeting coming up... :-))
Gonneke van Veldhuizen
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Date: Sun, 19 Mar 2000 16:51:28 EST
Reply-To: Lactation Information and Discussion
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From: Kathy Parkes <[log in to unmask]>
Subject: Re: more on pump sharing
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Both Medela and Hollister have written instructions on their Pump In Style
and Purely Yours (as well as DoubleEase, Mini-Electric, etc.) that they are
single-user items. I've had several company reps tell me that came from an
FDA regulation, although I cannot find it at the FDA website. Both companies
also state that sharing a pump voids the warranty immediately.
Kathy Parkes, RN, IBCLC
The Lactation Connection (TLC)
www.tlc4moms.com
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Date: Sun, 19 Mar 2000 18:09:47 -0500
Reply-To: Lactation Information and Discussion
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From: Kathleen Bruce <[log in to unmask]>
Subject: From KGA
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From Kathleen Auerbach.
You might want to read what Pardee Hinson reported about how the lactation
clinic (in-patient as well as out-patient) evolved at her hospital. She is
the director and is a NON-RN, but she is IBCLC certified. Her article is in
Current Issues in Clinical Lactation and she makes clear that the issue is
qualifications and what each person on her staff (not all are RNs) bring to
the job they are expected to do. Check it out. Perhaps it will touch on
both the issue of non-RN LCs and also the issue of certification...
Kathy Auerbach
[log in to unmask]
Kathleen G. Auerbach, PhD, IBCLC
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Date: Sun, 19 Mar 2000 18:34:28 -0500
Reply-To: Lactation Information and Discussion
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From: "Cindy Curtis, RN, IBCLC" <[log in to unmask]>
Subject: Re: More on Pump Sharing
For women who I know are financially
challenged I keep a private list of those I know willing to sell their used
pumps and refer them to web sites that I know auction or sell used pumps and
then get them all new accessories.
Do you all think this has any liability for us ? What if we tell mom A to
call mom B and mom B sells her the pump and she was Hepatitis positive and
then the other mom and or baby get hepatitis..... just thinking........
Cindy Curtis,RN,IBCLC
mailto:[log in to unmask]
http://www.erols.com/cindyrn
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Date: Sun, 19 Mar 2000 19:30:28 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Re: sharing pumps
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Just a thought on PIS contamination. If there is concern with bacteria
forming if milk gets into the motor with pump sharing this is a problem with
the original owner as well.
If this occurs frequently Medela should be looking into a way of correcting
the problem.
Has anyone seen this occur?
Ruth Solomon, RN, IBCLC
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Date: Sun, 19 Mar 2000 19:27:47 -0600
Reply-To: Lactation Information and Discussion
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From: SAK <[log in to unmask]>
Subject: ILCA conference dates.
Comments: To: Linda Rosetti <[log in to unmask]>
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The dates and location of the ILCA conference for 2000 are listed both on
the "conference" link and the "bulletin board" link on the ILCA website. I
will not list them here, as it is against LactNet policy to promote
conferences.
Additional information on this year's conference will be available on the
ILCA website as soon as I receive information from ILCA. Generally they do
send me a copy of the registration booklet when it is available.
Sue Ann Kendall
--
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*** Sue Ann Kendall * [log in to unmask] **
****** Brushy Creek (Austin) Texas, USA ******
*************ILCA Webfrau*********
************* www.ilca.org **************
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Date: Mon, 20 Mar 2000 11:30:24 +1000
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From: Virginia G Thorley <[log in to unmask]>
Subject: Restricted breastfeeding in 1940s/50s
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Hello,
Jean Cotterman describes the infant feeding patterns used in hospitals
in the 1940s/'50s, and the restricted duration of breast feeds. As one of
the mothers of the period I interviewed for my research so beautifully
pointed out, the baby was whisked away before her milk ejection reflex could
occur in the hospital setting. (That, of course, proved there was nothing
there.) It was sad to have other mothers lament that they felt they had let
their babies down by never producing enough milk, or that their bodies just
didn't product the milk. These were mothers whose babies were begun on
complementary bottles in hospital (a 10-day stay, later 7) and who valiantly
gave comps after breastfeeds for three months, before feeling they had lost
the battle. Others continued this mixed feeding even longer. For some, the
complementary bottle became a reassuring thing, in a culture where frequent
weighing and test feeds was given great emphasis. Weighing and clock
watching were exalted to dogma status, and mothers were under pressure to be
"good motehrs". The breastfeeding rate 1940-60 declined markedly, despite
(!) the encouragement given to brestfeeding. The methods worked for a few,
who has vigorous babies and big breast storage capacities, but set the rest
up for failure. Who would want to keep on failing at something, after all
the worry and angst of struggling with token breastfeeding? No wonder the
rate declined.
Sadly, a lot of us see some Mums who've been given some of the old
advice, even today, just when we think things are improving. But that's
another story.
It is difficult to estimate how many were exclusively breastfeeding in
postwar Queensland under the current definitions. Not a lot. Most gave
extras, e.g. vitamins, water, Vegemite (in water). Vegemite is a very salty
preparation, saltier than Marmite, and was then even higher in sodium, but
it was given to Queensland babies to provide vit. B1. It also raised fluid
needs, because of the sodium; and this was in a hot climate!
Cheers,
Virginia
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Date: Mon, 20 Mar 2000 11:48:22 +1000
Reply-To: Lactation Information and Discussion
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Sender: Lactation Information and Discussion
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From: Virginia G Thorley <[log in to unmask]>
Subject: Re: LACTNET Digest - 19 Mar 2000 - Special issue (#2000-359)
Comments: cc: [log in to unmask]
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Heidi,
Two more points you can add to your list are:
a) untreated tongue tie, where the child cannot adequately clear the teeth
of particles of solid foods, and
b) gastro-oesophageal reflux - which is going to happen more in relation to
being laid down to sleep
Virginia
> From: jhroibal <>
> Subject: Dental caries re-post
>
> I'm posting this info again for the person with questions about dental
> caries:-)
>
> There seems to be many conflicting opinions. I've investigated this
> issue thoroughly and several things pop into mind that may increase a
> child's risk for dental caries.
>
> absence of certain vitamins during mother's pregnancy
> certain medications taken during mother's pregnancy
> variations in enamel development
> an infant's state of prematurity
> family history of dental caries
> certain strains of highly acid producing bacteria in child's mouth
>
> There is an excellent article written from a pediatric dentist's
> perspective in LLLI's NEW BEGINNINGS, Jan-Feb. 1997 pages 10-12.
>
> Lots of treatment options/preventative measures are given, ranging from
> suggestions for mothers with a history of extensive dental caries to
> avoid sharing spoons with her child because of possible transfer of
> "bad" bacteria--to suggestions on how to manage oral flora.
>
> Parents are also urge to brush their child's teeth 3 -4 times aily and
> investigate appropriate fluoride options. I highly recommend this
> article.
>
> Heidi S. Roibal
> where the entire state experienced a black-out for about 3 hours Sat.
> night. Thank goodness breastfeeding doesn't require electricity!
>
> ------------------------------
>
> Date: Sun, 19 Mar 2000 16:53:22 +0000
> From: heather <[log in to unmask]>
> Subject: Re: routine weighing
>
> Carol says:
>
> >there are LCs (in my area) who believe it is necessary to do a test weigh
> >(before and after nursing) of EVERY mom/baby dyad they see.
>
> Really? But what are they looking for? "Adequate" intake in terms of
> volume? And how do they define that, knowing (as they must do) that it
is
> normal for the amount of milk to differ from feed to feed, and for the
> calorific value to differ from feed to feed, and knowing (as they must do)
> that this baby could wake up in 20 minutes (or less, or more) and have
some
> more.....
>
> >what, but i have been criticized for believing that test weighing is an
> >invasive procedure and should be used when needed.
>
> Of course it is invasive. But test weighing pushes my buttons, so I'm
bound
> to agree with you, Carol : )
> >
>
> >don't think it is warranted. who said moms look at the weigh in as an
exam
> >they are afraid they will fail? ever so true.
>
> And it's also true that in the UK, where health care at baby clinics is
> free, and available as a 'drop in' everywhere but the most rural (and even
> in rural areas, there are mobile clinics), and home visits are normal
> (though less common these days)...mothers are sometimes too scared to go
to
> the clinic because they are worried about the weighing (fortunately, test
> weighing is almost never done now, except in extreme situations). Mothers
> call volunteer counsellors, fretting about an up-coming clinic visit,
> because of what the scales will say....only too aware that in the wrong
> hands, this may take precedence over any other sign of health,
development,
> and 'competence' as a mother.
>
> I even felt it myself with my first two - even though I could see my
> gorgeous babies were thriving and I knew bf was going well. The anxiety as
> they were placed on the scales was acute. My third baby never went to the
> clinic at all except for immunisations.
>
> Heather Welford Neil
> NCT bfc Newcastle upon Tyne UK
>
> ------------------------------
>
> Date: Sun, 19 Mar 2000 12:54:08 EST
> From: [log in to unmask]
> Subject: Dave Barry
>
> Dave Barry's column today is on the difference between the male and female
> sense of humor, and includes an example from breastfeeding class about the
> cloth breast model ("kind of like a muppet"). My dh and I both LOL while
> reading it. <A HREF="http://www.herald.com/archive/barry/">Miami Herald
Online
> </A> or www.herald.com/archive/barry, click on the headline to read the
full
> text.
>
> Elaine Ziska
> Jackson, MS
>
> ------------------------------
>
> Date: Sun, 19 Mar 2000 13:00:53 EST
> From: [log in to unmask]
> Subject: Re: bf law
>
> Today's ( sunday 3/19) Chicago Tribune has a note on a Spanish law that
was
> invoked in court to reimburse a gentleman for money docked from his pay
for
> the time he took off to go home ( 1 hr. a day) to be with his wife and
> infant. The law on the books grants breaks to gov. employees with babies 9
> months old or less. The court ruled that the law did not distinquish
between
> male and female emplyees!
>
> Patricia
>
> ------------------------------
>
> Date: Sun, 19 Mar 2000 13:08:18 EST
> From: [log in to unmask]
> Subject: "normal" , engorgement and homebirth, n=1
>
> In a message dated 3/18/00 11:03:50 PM Central Standard Time,
> [log in to unmask] writes:
>
> << Can anyone in a home birthing practice compare this with what they are
> seeing in the first three days? >>
>
> My dd was born at home around 9pm, latched and bf vigorously within ten
> minutes, slept with me that night, and my milk surged within 24hrs. I was
> very full/engorged but didn't experience it as painful and didn't treat
it.
> I developed sore, cracked nipples (lazy positioning) by day 3 and then
severe
> mastitis by day 7. BF was never interrupted and she never lost an ounce.
>
> This time I'll manage the positioning and engorgement more aggressively.
> Pamela Morrisson has provided some suggestions, others are welcome.
>
> Elaine Ziska
> Jackson, MS
>
> ------------------------------
>
> End of LACTNET Digest - 19 Mar 2000 - Special issue (#2000-359)
> ***************************************************************
>
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Date: Sun, 19 Mar 2000 15:46:36 -0800
Reply-To: Lactation Information and Discussion
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: deep wound healing
Comments: To: [log in to unmask]
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Nikki Lee: For truly deed wounds or wounds with obvious infection or
copious drainage, I absolutely agree with you in terms of healing from the
inside out with packing in place. The problem here is that the wound is not
excessively deep or large and IMNSHO it could be ready to close. Current
thinking in wounds of this type is to get it closed as soon as possible (and
I've even seen the use of a vacuum instrument employed to suck long tunnels
closed and hold them closed for 48 hours until cell growth occurs). All of
this, of course, requires a trained clinician to evaluate it frequently--if
it starts to close and inflammation and redness are apparent, then packing
needs to be resumed.
For those who wonder how a non-hospital based, non-RN or MD knows this...my
recent absence from LN was due to a very poor surgical outcome resulting in
a 20 cm in diameter hole (7 cm deep) with 2 tunnels going 17 and 19 cm out
in either direction. The wound had 4 different bacterial infections, what
seemed like tons of necrotic tissue and required almost 6 months of a
variety of packing techniques, topicals, TENS (to stimulate blood vessel and
nerve growth, and vaccuum. The certified wound care specialist who treated
me was a God-send in providing many clinical documents on the "latest,
greatest" research and techniques.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Sun, 19 Mar 2000 20:59:32 EST
Reply-To: Lactation Information and Discussion
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From: Anne Williams <[log in to unmask]>
Subject: Yeast and Gentian Violet
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Ok, I have been a RN 20 yrs + and an IBCLC for 6 + years. I feel stupid or
uninformed at the least, but after reading experienced Diane's question and
her thoughts about yeast I am going to respond. This is purely anectdoctal,
but obviously a lesson I needed to learn to better help my patients in the
future. Last year while nursing my 3 1/2 year old I developed some form of
yeast. I 'lived' with it. After several months the breast pain was
unbearable, the classic knife cutting right through the center...I wanted to
literally rip my breast off. This happened before the great, latest JHL
article, so I went to the HMO clinic 'armed' with printed copies of Dr. Jack
Newman's article on yeast and Diflucan treatment only to have a new 'green'
MD female grad insistently say,"Who diagnosed yeast, I cannot order this
medicine for you! It is too expensive, my director would never approve this!"
She was so unsure of herself, it was pitiful. I immediately walked around
the corner to the patient representative and while waiting to talk to the
rep., asked to speak to the Pharmaceutical Director. He was older and wiser
and into customer service...he quietly read the literature and acknowledged
my personal expertise. He walked out and handed me the Diflucan needed to
supposedly erradicate the problem. Within two days, the discomfort was
tolerable. I completed 21 days of therapy and I thought the problem was
behind me. I was driven to end the breastfeeding relationship sadly, when my
son was 4 1/2. I did not want to repeat this scenario. The yeast did
return, remember the Diflucan does not kill the yeast. I e-mailed Dr. Newman
and he concurred to try gentian violet and repeat the Diflucan if the gentian
violet did not help. The gentian violet had to be special ordered from a
local pharmacy, but arrived in a day and only cost $1.67 for a fluid ounce.
The first time I applied it to my breast, the stabbing pain immediately
started. It was as though the gentian violet attacked the yeast and a
horrific battle was going on. I was amazed! I have been even more impressed
at how quickly the gentian violet improved my problem. Within 24 hours no
itching, burning or discomfort for the first time in about a year. I can
handle the purple breast, although I feel like I belong at Mardis Gras with a
tassle too! So, for those of you out there who knew this, please disregard,
but for those of you who are not familiar with gentian violet, I strongly
reccomend this be the first choice. Most of the literature states this and
most of the experienced LCs, I believe suggest this, but again we get caught
up in the latest. I certainly wish I had tried it before all that expensive
Diflucan that did not seem to work as well. So, yes Diane I would give a
purple toe a try too!
Sincerely,
Anne Williams RN BSN IBCLC
[log in to unmask]
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Date: Sun, 19 Mar 2000 21:00:37 EST
Reply-To: Lactation Information and Discussion
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From: Carol Brussel <[log in to unmask]>
Subject: Re: LACTNET Digest - 19 Mar 2000 - Special issue (#2000-360)
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In a message dated 3/19/00 6:39:50 PM Mountain Standard Time, << Just a
thought on PIS contamination. If there is concern with bacteria
forming if milk gets into the motor with pump sharing this is a problem with
the original owner as well.
If this occurs frequently Medela should be looking into a way of correcting
the problem. >>
excellent point! don't you think if this was a serious concern that it would
be fixed, since it would be just as dangerous for the original owner as a
subsequent user?
$$$$$$$
carol brussel IBCLC
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Date: Sun, 19 Mar 2000 21:09:31 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: breastmilk recalled
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I saw the recall on the baby formula and could not resist!
So many people tell me how they can't breastfeed for so many reasons.
98% of the reasons are goofy.
I can just see someone saying that their breastmilk was recalled.
Tupperware story: Yesterday at a party a mom saw that I was pregnant and
informed me that Tupperware has a tiny container that fits enough powdered
formula to mix for a bottle. She carried 5 of these for a day out. She said I
NEEDED this item. The host of the party knew I was an IBCLC and started
laughing.
Annette L.
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Date: Mon, 20 Mar 2000 08:13:43 -0600
Reply-To: Lactation Information and Discussion
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Sender: Lactation Information and Discussion
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From: Paula Lvingston <[log in to unmask]>
Subject: Loestrin
This birthcontrol pill has been taken for 3 months by a mom who's
milk is suffering from low milk supply. The doctor has put her on FEl.5.30
amount. Does anyone know about this one?
Please reply to:
Paula Livingston
[log in to unmask]
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Date: Sun, 19 Mar 2000 20:30:40 -0600
Reply-To: Lactation Information and Discussion
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From: Jim & Winnie Mading <[log in to unmask]>
Subject: Pre & post feed weights
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We have a scale for this purpose in outr office, but do not use it
routinely. When there is any question about how much baby is
transferring, we do use it. I always tell a mom beforehand that the
weights do not give us a full picture of what is happening over all
the feedings in a day. It is more of a "snapshot" of that
individual feed. I also ask mom after the feed and before the post
weight how she feels that feeding went in comparison with a typical
feeding for the baby. Test weights (or whatever you prefer to call
them) are only one tool, but they can be a helpful one. In a
situation where baby definitely needs to be fed and mom is working
on her supply but is not obtaining as much (whether she is using a
mechanical pump or hand expression) as baby needs, test weights can
give a "ballpark" idea of how much additional milk baby may need to
be taking in by whatever alternate feeding method is appropriate for
that situation. I think it's a better approach than the one most
Peds use where they always tell a mom "give 1-1 1/2 ounces after
every feeding" regardless of any evidence as to what baby is
obtaining at the breast.
Winnie Mading-Wisconsin- who is exhausted after 2 days of constantly
cutting and polishing stones at our gem and mineral show. I cut 22
in the 2 days!
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Date: Mon, 20 Mar 2000 08:16:19 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Paula Lvingston <[log in to unmask]>
Subject: Writing a constitution
Has anyone written a constitution for the IRS to become 501c3 eligible?
This will be for a grant to increase breastfeeding along the
Mexican border.
email me :
Paula Livingston
[log in to unmask]
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Date: Sun, 19 Mar 2000 22:01:56 -0500
Reply-To: Lactation Information and Discussion
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From: Stephen Curless <[log in to unmask]>
Subject: sore nipples
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Hi. I am dealing with a very difficult case of sore nipples that is not
responding to most techniques. With years of experience as a LC, this is
one of the most difficult to resolve.
Mom has a history of sore nipples with all her children. She quit
nursing with first child due to severe "chewed" sore nipple. I worked
with her on others and she successful after dealing with mild
soreness.This baby is now 4 weeks old, mom cannot grasp correct latch
technique. There is no problem with thrush, tongue tie, or other
problems. Baby has not had bottles or pacifiers.Milk supply is low. She
is using SNS on least sore side due to baby's weight and pumping after
each feeding. (hospital grade pump). We have tried hydrogel (better one
-mom does not like this). OB doctor ordered an
antibiotic/anti-inflamatory creme which is helping.
The same nipple that caused most problems with all children is still the
problem one. It is healing now and we will continue to pump and do a
consult in few days to start on this side again.It helped to hear
BarbaraWilson-Clay express how she felt when all her usual methods did
not work on a one of her cases. Any ideas would be appreciated.
Helen
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Date: Sun, 19 Mar 2000 22:29:47 -0500
Reply-To: Lactation Information and Discussion
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From: "Paula M. R. Hart" <[log in to unmask]>
Subject: Kneading (human this time)
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First, sorry for being so behind, but I was just reading the thread on
kittens being weaned early and always kneading. I, too, have heard this.
I have found that all of my cats did this, but I figure that they were all
probably weaned early by the owners of the mother who wanted to get rid of
annoying kittens before they lost their cuteness. However, I am wondering
what anyone would make of my son. He is currently 10 months old. He has
been kneading since he came out. He gets very frustrated if he is nursing
and I won't allow him to knead my breast. It can get painful at times, so
I usually try to slip my fingers in the way to TRY to get him to knead them
instead. I certainly have copious amounts of milk, but wonder if he is
addicted to the faster flow. More of a curiosity thing for me as neither
of my girls did it. My DH maintains he inherited it from him (laughingly
since DH was definitely NOT bf)! Any ideas?
Paula Hart
[log in to unmask]
Charleston, SC
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Date: Sun, 19 Mar 2000 22:31:33 EST
Reply-To: Lactation Information and Discussion
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From: Anne Merewood <[log in to unmask]>
Subject: Re: tub baths
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No Jan, we are not tub bathing babies in the nursery. We are tub bathing in
the mother's room and trying to CLOSE the nursery!!!! We did several
'experimental' baths. The walls did not fall down. Once we have figured out a
way to pay for enough tubs, we will clean up every baby this way...
Anne Merewood IBCLC
Director of Lactation Services
(Baby-Friendly) Boston Medical Center
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Date: Sun, 19 Mar 2000 23:23:46 -0500
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From: Becky Flora <[log in to unmask]>
Subject: tingling sensation in legs only when breastfeeding
Hi all,
I have a mother who complains of tingling sensations in her
legs only
when breastfeeding. Position of the baby or her body doesn't
seem to
make a difference. She says she can sit in the same position
before
and after breastfeeding and be fine. Only when actually
nursing does
she experience these sensations. This is a new occurrence for
her.
Baby is 10 weeks old. Mother did mention excessive postpartum
bleeding; almost was transfused. CBC levels a month ago were
normal.
Any ideas? I'm stumped!
Becky Flora, BSed, IBCLC
Kingspor
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Date: Mon, 20 Mar 2000 01:22:59 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Bf earlier in the century
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Virginia wrote about mothers in the 1940s who couldn't let down before their
babies were whisked away by the clock watchers.
My husband's grandmother, now 87, had in a way the opposite experience when
her first child was born in Boston in the 1930s. She had "plenty of milk but
my milk was too thin, it wasn't rich enough" so that the baby "had colic" and
didn't gain weight.
My theory of this now is that the mother was engorged, the baby only allowed
to stay at the breast long enough to take off a little of the copious
foremilk, and the result was a nasty lack of hind milk.
Leading of course to the same result -- the saving power of infant formula :(.
Elisheva Urbas, NYC
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Date: Mon, 20 Mar 2000 08:53:41 +0100
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From: Rietveld <[log in to unmask]>
Subject: Re: breastmilk recalled
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Hi Annette,
If the ones you mention are the same ones I have in mind, than I *have* to
say that I use them for............ CUPFEEDING !!!!! (and for a rolled up
wet wascloth for the ones on LN who know The Dutch wascloths, easy when on
a trip and one needs to wipe a dirty face ;-))
I don't have any financial interest in this product (on the contrary I'd
say, this stuff is expensive......).
Regards,
Renate RIetveld, IBCLC
Rijswijk, The Netherlands
At 21:09 19-3-00 EST, you wrote:
>Tupperware story: Yesterday at a party a mom saw that I was pregnant and
>informed me that Tupperware has a tiny container that fits enough powdered
>formula to mix for a bottle. She carried 5 of these for a day out. She said I
>NEEDED this item. The host of the party knew I was an IBCLC and started
>laughing.
--------------------------------------------------------------
Renate Rietveld, IBCLC
E-mail : [log in to unmask]
Homepage: http://www.casema.net/~rietveld/index.htm
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Date: Sun, 19 Mar 2000 23:58:32 +0000
Reply-To: Lactation Information and Discussion
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From: ron garcia <[log in to unmask]>
Subject: tub baths
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Our hospital is also about to close the nursery, and we have started
doing tub baths after delivery. We have two little push-around carts
that have been set up with regular plastic baby bath tubs on the top
shelf, and all of our admission stuff for baby on the bottom two
shelves. This is rolled from its storage place into the birthing rooms
as needed, and the tub is cleaned according to hospital protocol after
each use. Our very progressive department manager convinced the Peds
drs to go along with emersion, and they seemed to cave without a fuss.
It was a little harder for the nurses, but we plan to be baby friendly
in a year, and they are having to adjust to quite abit! Their incentive
is the fact that we are getting remodeled birthing rooms, starting next
month, and will have jetted tubs for laboring, and special sinks in the
rooms just for bathing the babies. Then we won't need the push-around
carts anymore! Hopefully our breastfeeding rate will continue to climb,
and everyone will be happy.
Rebecca Garcia RNC,IBCLC
Remodeling in Walla Walla Wa. where spring has sprung, and the Blue Mts.
are blue again.
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Date: Mon, 20 Mar 2000 09:16:46 +0100
Reply-To: Lactation Information and Discussion
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From: Rietveld <[log in to unmask]>
Subject: Sore nipples, oops wasn't finished yet :-)
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Hi Helen,
Since you've said that ANY ideas are welcome, I'd like to tell you what
came to my mind.
The only thing that seems to help a little here is the
antibiotic/anti-inflammatory creme. Isn't it an idea to use Dr. Newman's
APNO (=All purpose Nipple
Ointment) instead?
It contains Mupirocin 2% ointment (15 grams)
Nystatin 100,000 unit/ml ointment (15 grams)
Clotrimazole 10% (vaginal cream) (15 gram)
Betamethasone 0.1% ointment (15 grams)
A pharmacist mixes it together and it's applied sparingly after each
feeding.It doesn't have to be washed or wiped off. You need a prescription
for it.
You can find more info on this at Http://www.erols.com/cindyrn/drjack0.htm
or Http://www.bflrc.com/
You can also check the Lactnet archives, but there has once been given a
description of this medication that had a typo in it, so I'll advise you to
check out Dr. Jack's handouts (esp. #24; treatment for problems) as well.
My bet is that you'll get more replies, but I just wanted to share this
with you (although you've probably thought about this yourself too).
Kind regards,
Renate Rietveld, IBCLC
Rijswijk, The Netherlands
OB doctor ordered an
>antibiotic/anti-inflamatory creme which is helping.
>The same nipple that caused most problems with all children is still the
>problem one. It is healing now and we will continue to pump and do a
>consult in few days to start on this side again.It helped to hear
>BarbaraWilson-Clay express how she felt when all her usual methods did
>not work on a one of her cases. Any ideas would be appreciated.
--------------------------------------------------------------
Renate Rietveld, IBCLC
E-mail : [log in to unmask]
Homepage: http://www.casema.net/~rietveld/index.htm
--------------------------------------------------------------
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Date: Mon, 20 Mar 2000 09:26:29 +0100
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: Kneading (human this time)
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> Paula Hart wrote: However, I am wondering
> what anyone would make of my son. He is currently 10 months old. He has
> been kneading since he came out. He gets very frustrated if he is nursing
> and I won't allow him to knead my breast. It can get painful at times, so
> I usually try to slip my fingers in the way to TRY to get him to knead them
> instead. I certainly have copious amounts of milk, but wonder if he is
> addicted to the faster flow. More of a curiosity thing for me as neither
> of my girls did it. >
Paula, perhaps he's doing dr. Jack's deep compression technique? :-)
I've seen kneading, caressing, opposite-nipple-pinching, and all sorts of
manipulating by breastfeeding infants.My youngest, who co-slept for years after
weaning, kept searching (in his sleep) for my bare breast skin to touch when I
slipped into bed at night. He never reacted when dad came in.
I think we find it quite normal in our society to see non-breastfed children
carry around blankets, cuddling teddybears, using littles pieces of cloths, etc,
(I've seen one with a little piece of a plastic diaper wrap,) but I also think
that that might be substitute behaviour for the kneading and thelike.
> My DH maintains he inherited it from him (laughingly
> since DH was definitely NOT bf)! Any ideas?
M dh wasn't much either as a baby, but he still searches for *my* breasts in bed
...
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
http://www.users.skynet.be/eurolac
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Date: Mon, 20 Mar 2000 09:32:17 +0100
Reply-To: Lactation Information and Discussion
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: breastmilk recalled
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> If the ones you mention are the same ones I have in mind, than I *have* to
> say that I use them for............ CUPFEEDING !!!!! (and for a rolled up
> wet wascloth for the ones on LN who know The Dutch wascloths, easy when on
> a trip and one needs to wipe a dirty face ;-))
A Dutch washcloth is kind of cottonwool pouch to put your hand in to wash your
body/face.
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
http://www.users.skynet.be/eurolac
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Date: Mon, 20 Mar 2000 09:39:02 +0100
Reply-To: Lactation Information and Discussion
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: More on Pump Sharing
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> Do you all think this has any liability for us ? What if we tell mom A to
> call mom B and mom B sells her the pump and she was Hepatitis positive and
> then the other mom and or baby get hepatitis..... just thinking........
>
> Cindy Curtis,RN,IBCLC
Cindy, I don't know for other countries, but for me it would do if I educated
the buyer to sterilise/clean the pump as good as possible, have her buy a new
personal set and explain the mechanics of possible disease transfer via
breastpumps AND point out her OWN responsibility if using a second hand pump.
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
http://www.users.skynet.be/eurolac
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Date: Mon, 20 Mar 2000 20:24:03 +1000
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From: Kay Family <[log in to unmask]>
Subject: Timing of breastfeeds
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In our Unit (1400 births/yr) in Australia, if the baby has had a good
witnessed breastfeed shortly after birth, they are left for 12 hours before
we begin to be concerned. Even then we don't do blood sugars, unless we have
a good reason.
After 12 hours, they are changed, unwraped, and encouraged to feed.
If no feed, they have a full set of obs done, then observed for feeding cues
for another couple of hours, being tucked into bed with mum, with lots of
skin to skin and mum being asked to ring for us if baby seems interested.
Rarely do we have to go past this with a well, term baby, but if so, mum may
express (by hand) and whatever she gets is given to baby by spoon, syringe,
or cup. (Still no blood sugars!)
I was involved in changing our guidelines last year, rang many other
hospitals, did lit. searches etc- very little is actually committed to
paper!
Our guidelines seem to work well, we have not seen any increase in jaundice,
dehydrated babies or all the other usual arguments.
Best wishes
Susan in Qld Australia
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Date: Mon, 20 Mar 2000 18:43:10 +0800
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From: Kirsten Blacker <[log in to unmask]>
Subject: Re: tub baths
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I'm not sure if what you mean by tub baths is what I mean by tub
baths....but...
In the hospital where I both work and had my babies, the private postnatal
rooms have a large handbasin in each room that is shaped like a baby bath.
They are stainless steel, and are cleaned inbetween patients. Also, I
personally give the sink a quick 'swish' with disinfectant and then rinse
before each baby bath, because the sink is also used for handwashing.
Which is pretty much the same as what I did at home when I bathed my boy in
our laundry sink. At 4.8kg born, he was too big for a baby bath!!
Kirsten Blacker
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Date: Mon, 20 Mar 2000 22:49:46 +1100
Reply-To: Lactation Information and Discussion
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From: Grant & Louise McLeod <[log in to unmask]>
Subject: tub baths
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Anne, to save buying baths why not bath the baby in it's plastic cot?
Take mattress out, fill up with water and bathe. Empty with a jug and =
wipe out with a towel and then a large alcohol wipe.
Cot is washed thoroughly between babies as usual.
Where I currently work we use a change table to dress/ undress the baby =
but in other places we just pumped up the bed to a comfortable height =
for mum/dad/midwife.
=20
Louise Dimmock McLeod
RN Midwife IBCLC
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"The cure for anything is salt water - sweat,tears or the sea"
Isak Dinesen
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Date: Mon, 20 Mar 2000 06:15:19 -0600
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From: Kathy Dettwyler <[log in to unmask]>
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>No Jan, we are not tub bathing babies in the nursery. We are tub bathing in
>the mother's room and trying to CLOSE the nursery!!!! We did several
>'experimental' baths. The walls did not fall down. Once we have figured out a
>way to pay for enough tubs, we will clean up every baby this way...
Anne, and others,
Would it be too radical to suggest that babies not be bathed at all
in the hospital? That a warm flannel blanket (or something similar) be used
to cover them on the mother's abdomen/chest, and the family be left alone to
wipe off any obvious goo that they don't like? And that the family be told
that cleaning the baby's hands, especially, is not a good idea for the first
day or two? And that the vernix should be rubbed in, not washed off, and
that baby's skin is very fragile and needs to be treated gently (not
scrubbed) in the first few days? And that the baby needs to be kept warm on
the mother's chest (explain how her body will automatically warm up to keep
the baby warm) and that getting the baby cold with a water bath is an
unnecessary stress on the baby's temperature-regulating system for the first
day or two after birth? And that getting the baby's umbilical cord wet will
not hurt it? And show them how to bathe the baby in the family tub on the
lap of an adult instead of on the kitchen counter in one of those plastic
baby tubs?
Kathy Dettwyler
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Date: Mon, 20 Mar 2000 12:27:08 -0000
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From: Magda Sachs <[log in to unmask]>
Subject: weighing
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Pat, you said:
Baby's weight and progress in this area, according to Hrdy is something
that all parents have always honed in on, as a predictor of baby survival.
I know parents are definetely preoccupied with kids' weight. No one (but
me) seems to worry about overfeeding kids, but let me tell you that all
parents focus on "too skinny", "doesn't eat enough", "small appetite",
"eats NOTHING" ad nauseam every day in the ped office! (and culturally
some parents are worse about it.)
I haven't had the pleasure of Hrdy yet (not in pb in the UK). I am
interested in the idea that *all* parents *always* honed in on this as it
may then make it pretty much a unique event!!
However, what you say is that parents are pre-occupied with weight, but your
examples are about observation of physical characteristics (skinniness) or
behaviour (eating patterns). Weight is a way of attempting to quantify the
observation about physical shape and behaviour. But one could argue that
skinniness could be better measured by other means (skin-fold thinckness,
for example) where there is any reason for concern, or where you want to
measure that aspect of growth. Behaviour, well that's interesting. Are
issues about behaviour assessable and addressable with weighing? There is
certainly such a discourse around adult weighing: dieters talk about 'being
good' and this is measured by weight loss or maintainence.
I actually think weighing has grown to be phenomenally misused and abused,
rather than it is in itself intrinsically useless. However, the general
misunderstanding about what it can tell us probably makes it a double-edged
tool.
Magda Sachs
Breastfeeding Supporter, BfN, UK
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Date: Mon, 20 Mar 2000 07:44:21 EST
Reply-To: Lactation Information and Discussion
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Anne says,
<< No Jan, we are not tub bathing babies in the nursery. We are tub bathing in
the mother's room and trying to CLOSE the nursery!!!! We did several
'experimental' baths. The walls did not fall down. >>
Oh dear Anne, I shouldn't be reading this heresy this early in the morning.
I might have a heart attack. To think there is someplace in the U S of A
that allows babies in the tub. Whether it is in the nursery or in the
mothers room. I bet you don't prohibit mothers from taking a tub bath too
when they get home, do you, because the dirty water in the bath might go up
the vagina and cause an infection of the uterus???
OK Lactnetters (this is to the US folks only -- I know the Aussies & the
Europeans are already enlightened). How many of you know for sure that your
hospital facility not only ALLOWS (whew, what a word) mothers to tub bathe
their babies before the cord detaches, but gives babies tub baths in the --
gulp -- HOSPITAL?
Anne, I certainly hope you are doing a double blind, case controlled study so
this won't be anecdotal. We wouldn't want to do anything that isn't research
based.
Jan -- cynical at this early time of day.
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Date: Mon, 20 Mar 2000 07:01:07 -0600
Reply-To: Lactation Information and Discussion
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From: gima <[log in to unmask]>
Subject: Re: bathing babies
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>Anne, and others,
> Would it be too radical to suggest that babies not be bathed at all
>in the hospital? That a warm flannel blanket (or something similar) be used
>to cover them on the mother's abdomen/chest, and the family be left alone to
>wipe off any obvious goo that they don't like? And that the family be told
>that cleaning the baby's hands, especially, is not a good idea for the first
>day or two? And that the vernix should be rubbed in, not washed off, and
>that baby's skin is very fragile and needs to be treated gently (not
>scrubbed) in the first few days? And that the baby needs to be kept warm on
>the mother's chest (explain how her body will automatically warm up to keep
>the baby warm) and that getting the baby cold with a water bath is an
>unnecessary stress on the baby's temperature-regulating system for the first
>day or two after birth? And that getting the baby's umbilical cord wet will
>not hurt it? And show them how to bathe the baby in the family tub on the
>lap of an adult instead of on the kitchen counter in one of those plastic
>baby tubs?
Kathy, thank you for your post. I was just sitting here wondering if I
dared say that the next step in our journey toward health care, after the
experimental bath in the mother's room, is to do away with the bath
altogether, leaving the protective gift of the vernix on baby's tender
skin, avoiding the soaps which invite bacterial and yeast infections,
allowing the normal, healthy smells of a *her* newborn to penetrate mom's
nostrils. At least inviting consideration of this change is a beginning.
We had a thread last year on hospital baths for newborns. We really need to
discontinue the practice, but it will take years of "research" and studies
to "prove" the many harmful effects of that "first bath." If anyone really
believes that washing an infant with antibacterial soaps will protect the
staff from HIV, she/he needs to re-examine the nature of viruses. I think
that this is just another bodily fluids issue.
Even the practice of alcohol on the umbilical cord is dying a hard death
here in Milwaukee. A couple of hospitals are "up to date" on the latest
research that the cord comes off sooner, and with no untoward effects, when
it is left alone, that it is not germy, and that the alcohol ritual is one
fewer thing that a mother must get "right." Hopefully that instruction time
will be replaced by instructions on holding, stroking, feeding on cue,
baby's first-night adjustment to her "real" home, and the importance of
basic help in the home during the adjustment period.
If we do away with the bath, we will free up even more time for teaching
for health for this new baby and mother, including time for getting feeding
off to a good start.
Kathy, I like your gentle way of introducing this consideration. "Would it
be too radical to suggest..."
At least we are on the way...
Pat Gima, IBCLC
Milwaukee, Wisconsin
Mailto:[log in to unmask]
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Date: Mon, 20 Mar 2000 12:51:57 +0000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: heather <[log in to unmask]>
Subject: Re: bathing babies
In-Reply-To: <[log in to unmask]>
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Babies aren't often bathed in hospital in the UK.
I would like to think the reason is that midwives and policy makers
recognise the points KD raises in her post, and that bathing is not only
unnecessary (at best) but invasive (at worst)....but I think it's more
likely pure pragmatism. When mothers are only in hospital for a short time,
there's just no spare time, or staff, for stuff like bathing. Good : )
However, it's never been a priority. My first baby was born 20 years ago,
and I was in hospital with her for 7-8 days - normal, then. She wasn't
bathed at all, but that was definitely because of staff priorities, as I
remember staff saying 'we'll give her a bath tomorrow' and then forgetting.
This is cultural, I suspect. The UK had indoor bathing facilities in the
home as a routine about a generation after the US, I would guess, and we
came a lot later to daily bathing and showering than all you clean North
Americans : ) My first job was in a working class, but not deprived,
area of South Wales in 1975, and the family I lodged with had only just got
their first indoor bath - which I was 'allowed' to use twice a week : O
Now, it's normal to shower once a day (or twice, in the case of my
late-to-be bathed first born....)
Heather Welford Neil
NCT bfc Newcastle upon Tyne
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Date: Mon, 20 Mar 2000 08:06:48 -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: Status
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Hello all, we're back from Houston and the hospital.
I want to thank you all for your wonderful support, encouragement and
prayers. All went well with Dan's surgery and we are back home during
his recovery time.
We are still awaiting my Dad's cardiac procedure, scheduled for 3/27/00,
so I will continue to be NO MAIL for a few more weeks. Please feel free
to contact me individually if you want to.
Boy, I really feel "out of the loop"!
Thanks,
Denny Rice, RN, IBCLC
Dallas Texas USA
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Date: Mon, 20 Mar 2000 10:10:49 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: Pump Sharing
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This is a very frustrating topic for most of us who sell products to
mothers. Personally I find the thought of sharing a used breastpump quite
disgusting. Yes I do have an interest in selling more pumps because I would
like to stay in business and be here to help more mothers breastfeed. I get
very frustrated with mothers who need a pump to continue to provide their
infant with their own milk, complaining about spending $250.00. How much is
spent on bedding, swings, carriers(the bucket kind) nursery monitors wall
paper, paint, fabulous clothing.? I tell women that it is a relitively short
time in your babys life that they can receive your milk, Surely this is worth
$250.00 if pumping is necessary!! ( and this is a whole other argument) Lets
Also explore the costs of the alternative; FORMULA. When you compare the
cost of getting a good pump to the costs of formula supplementation or
feeding, well there is no comparison.
Even if you do not buy into the risk of contamination theory, What about
the mothers who are having supply problems and you try all the remedies you
know, they are ready to give up, and then you find out they are in fact using
a friends pump in style. Oh, she only used it for FOUR babies she tells you,
it was one of the first ones ever made, These things should last forever!!
It costs $250.00 after all. The fact is that if a mom does not know how the
pump should feel and perform at peak performance, as New ones perform she has
nothing to go by. Surely I can't be the only one who has encountered this.
I do sympathize with the mothers who have true financial need. We have
WIC for them here that provides a good pump at no cost. Lactinas for moms
with preemies at no cost. We need even more money and help for WIC to help
these mothers. But as far as the majority of women who shop at my store, I
never reccomend sharing a pump or buying a used one. I just don't think it
is a good idea.
The most truly frustrating situation I encounter is the mom who brings
in her friends old used, filthy, pump in style, and wants ME to show her how
to clean it, and how to use it!! FOR FREE. I politely refuse.
[log in to unmask] Jessica Donahue RN IBCLC
Expressly For You.... Everything for the nursing mother!
Makers of Express Pouch breastmilk storage bags
<A HREF="http://www.expresslyforyou.com/">www.expresslyforyou.com</A>
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Date: Mon, 20 Mar 2000 10:12:50 -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: Re: Pump Sharing
"The most truly frustrating situation I encounter is the mom who brings
in her friends old used, filthy, pump in style, and wants ME to show her how
to clean it, and how to use it!! FOR FREE. I politely refuse."
I charge to do the above........... ;-)
Cindy
Cindy Curtis,RN,IBCLC
mailto:[log in to unmask]
http://www.erols.com/cindyrn
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Date: Mon, 20 Mar 2000 09:33:26 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Mary Kay Smith <[log in to unmask]>
Organization: Sinai Health System
Subject: a kind request
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Could those of you who reply by hitting the reply button please PLEASE
make a new message to lactnet with an appropriate subject? It is REALLY
annoying when someone resends an entire digest with an answer, and the
topic is "lactnet digest, date, blah, blah." Topics won't come up in an
archive search and we don't know what the reply is addressing.
Thanks in advance
Mary Kay Smith, IBCLC
Romeoville IL near Chicago
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Date: Mon, 20 Mar 2000 09:49:24 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Mary Kay Smith <[log in to unmask]>
Organization: Sinai Health System
Subject: Getting good information on Pumps
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I can't resist jumping in on the recent thread on pumps and
contamination. Anyone without experience with pumps could ask a pump
company rep to visit them (or talk at a conference when the table is not
busy) and see how the pumps work. Studies from the 1980's that "prove"
potential for cross-contamination from electric breast pumps are FLAWED
in several ways. Cross contamination can occur only when contaminated
milk is aspirated into a pump and the milk remains "live." Only then can
potential contamination occur. The study that I always got thrown in my
face used a kit that was improperly assembled so that the overflow
bottle to protect the pump was not connected.
ALL new breast pump kits (Hospital grade electric accessory kits)
contain a filter or type of barrier so that does not happen. Even in the
case of a PNS being used, if the milk inside the motor is dry, no
contamination can really occur. Are we worried about dried blood? Are we
worried about dried milk? Even if it was teeming with organisms when
"live" should we be afraid of it? There are many good resources that
explain how pumps really work; check out Marsha Walker's articles in
MCN, the chapter in Riordan & Auerbach (which I believe was co-authored
by Marsha) and Kittie Frantz's "breastfeeding product guide." I still
think that there is a need for conference sessions to address how pumps
work for those who are new to the field. The best education I ever
received was by attending a UCLA course(s) (CLE) where Kittie
demonstrated almost every pump & device on the market at the time. Those
sessions were the inspiration for her book.
Hoping that this will create clarity, not confrontation
Mary Kay Smith, IBCLC
Romeoville IL near Chicago
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Date: Mon, 20 Mar 2000 10:33:07 -1000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Pam Easterday <[log in to unmask]>
Subject: dental caries, caffeine and syrups
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In the discussion on dental caries, I haven't seen anyone bring in the
solution that halted our family tradition. Stopping caffeine. My
ex-husband and I have mouthfuls of cavities. Our children, 7,9 & 15, have
none. In animal studies, caffeine in pregnancy and lactation is a
cariogenic (cavity-causing) agent.
In preschool children, syrup medicines, especially antibiotic syrups, have
been shown to contribute to caries as well.
I have a dentist to thank for alerting me to the caffeine connection 20
years ago. Pam Easterday LLLL
Nakamoto, T. et al. Cariogenic effect of caffeine intake during lactation on
first molars of newborn rats. Archs Oral Biol 1993; 38(10):919-22.
Schneider, P. et al. Effects of caffeine intake during gestation and
lactation on the acid solubility of enamel in weanling rats. Caries Res
1995; 29:285-90.
McMahon, J. et al. Diet and dental caries in preschool children. Eur J Clin
Nutr 1993;47:794-802.
These references came from LLLI's Facts about Breastfeeding sheets, 1995 and
1997.
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Date: Mon, 20 Mar 2000 10:55:17 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Lorri <[log in to unmask]>
Subject: Guava leaf remedy
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I have a friend living in Ukarumba, Papua New Guinea for the next few years
who sent me this question in her latest missive. Can any of you plant/drug
savvy souls shed some light that I could pass on to her? How about some of
you living closer to her part of the world...heard of this? used it while
bf?
"My latest "quest" is to research alternatives to the standard prophylaxis &
treatment for malaria. I had it a couple of weeks ago & between it & the
treatment, it is by far the sickest I have ever been! It was the variety
that tends to recur when your defenses are down (which they were), so I am
working on boosting my immune system, etc. Anyhow, I have heard from several
people here that they use guava leaves (grows here) to make a tea which they
drink weekly for prevention & for a few days to treat malaria. They claim it
is without side effects (a big plus compared with chloroquine or quinine!) &
works better. The question I have & no one seems to know is, is it safe
during pregnancy & lactation? I suspect there is no research on it & since
it is a homemade thing it is hard to standardize doses."
TIA, and it would be great if you could reply privately as well as to the
list.
Lorri Centineo
Portland, Maine USA
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Date: Mon, 20 Mar 2000 10:36:13 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: Kathy Dettwyler <[log in to unmask]>
Subject: New subject headings
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>Topics won't come up in an
>archive search
This isn't true. The archive searches look for the word you request in the
body or the subject line. So the subject line can say whatever it wants.
Kathy Dettwyler
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Date: Mon, 20 Mar 2000 11:45:14 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Sharon Knorr <[log in to unmask]>
Subject: Wolf and Glass/infant feeding and swallowing
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I would like to thank the W/P/R Lactation Consortium for sponsoring the=
wonderful conference this past weekend, 2 days with Robin Glass and Lynn=
Wolf, both OTs who specialize in infant feeding and swallowing. The=
audience was about evenly split between OTs and LCs and the sharing and=
networking that went on was fantastic. We all learned from each other,=
both about what we do and how we do it. I have heard this presentation=
criticized in the past for its lack of mention of breastfeeding as an=
option for any of these infants/children. This was due in part to the=
fact that these people see so very few that are breastfeeding. However,=
they modified the presentation to be very inclusive of breastfeeding and=
it was great. Not only did the LCs appreciate it, but so did the OTs who=
really would like to be more supportive of breastfeeding, but often lack=
any knowledge or background in it. Many of us hooked up with local people=
in our areas and hope to do more cooperative work with these babies in the=
future.
I had breakfast with a different OT each morning. One interesting topic of=
conversation was qualifications, training and certification in both=
fields. I was interested to know how the OT profession had evolved and=
where it was today. She told me that it mainly started after WWI when=
nurses were trying to find ways to help the returning servicemen, many=
with awful injuries - both mental and physical - to get back into some=
type of normal lifestyle. They found that just helping them to do=
everyday tasks which would lead them back into some type of productive=
life was the most important in many cases. After this initial start, the=
profession went along in fits and starts, sometimes leaning towards a more=
physical therapy type of approach and other times towards the original=
emphasis on occupational or life skills, which is where they have settled=
out at this time. Since feeding is a basic life skill, this is a=
specialty for some OTs. She told me that soon, a master's degree would=
probably be considered the ENTRY level requisite for this field. I say=
this in order to remind those who are uncomfortable with the future plans=
of IBLCE for entry level requirements into the lactation profession. If=
we want to be a true health profession, and not become simply a nursing=
specialization or a quasi-lay/professional, then we must be willing to do=
the work that other health professionals do in order to gain entry into=
their respective fields. In OT, experienced therapists were originally=
grandfathered in as the requirements became more stringent. I think that=
this can be done for LC's as well, but at some point, a line will need to=
be drawn for those who are aspiring to enter the field for the first time.
If anyone is able to get to one of these conferences, I would strongly urge=
you to do so. The information I gained was invaluable and it was the kind=
of stuff that I hope to see included in a formal LC curriculum in the=
future. Thanks again to the folks in downstate NY for all their hard=
work.
Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
mailto:[log in to unmask]
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Date: Mon, 20 Mar 2000 06:57:16 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: maka laughingwolf <[log in to unmask]>
Subject: need a local LC
Comments: To: radicalbreastfeeding <[log in to unmask]>
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(i'm still n*mail on lactnet)
=20
sorry, lactnetters, i know we're not supposed to ask for personal help =
here, but if someone is in the yakima valley, washington area, PLEASE =
PLEASE email me privately. i am in a situation of possibly needing =
surgery in the next few days and i know i will need help with managing =
breastfeeding and drugs as well as buffering with the hospital staff to =
maintain breastfeeding. my 8-1/2-month-old son is still almost =
exclusively breastfed (the only thing he eats is crackers, etc. to keep =
him occupied while i'm eating--shows no interest in food beyond that =
yet) and has never had a cup, bottle, or pacifier, and i'd like to keep =
it that way if possible.
thanks in advance...
Maka Laughingwolf
breastfeeding peer counselor
studying toward eventual IBCLC
***NOMAIL*** while en route
to new (temporary) home in Yakima, WA
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Date: Mon, 20 Mar 2000 09:02:14 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: baths
Comments: To: [log in to unmask]
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Kathy: I have to say that I 100% agree with you, but you wouldn't believe
the opposition to idea of not bathing a baby in the hospital. With my 3rd
son (22 months ago) I had to practically stand on my head to DELAY the bath
as long as possible. I kept saying "oh, he's nursing" or "he's asleep" or
"we are about to have visitors." The midwifery literature actually states
that bathing of any sort is harmful because of the removal of beneficial
lubricants, scents, and of course m-b separation. After 24 hours of arguing
(I had a c/section and was in for 3 days), I finally gave in. They were
literally harrassing me about it every 15-30 minutes and it simply wasn't
worth it. The hospital staff acted as though I was abusing my child by not
consenting to a bath.
Warmly,
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Mon, 20 Mar 2000 12:23:34 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: "Cindy Curtis, RN, IBCLC" <[log in to unmask]>
Subject: Re: baths
We recently had a mom who kept delaying the bath where I work, I saw no
problem with it but some of the other nurses were freaked out and finally
the clinical director of our unit came and got the baby and bathed him
because mom was a beta strep carrier, she was treated in labor with
antibiotics . Mom "consented" reluctantly, I felt bad for her. Tried to
talk to the director but she was afraid with mom being a b strep carrier
that baby had a greater chance of getting it the longer the bath was
delayed. I don't have any info on this, do any of you?
Thanks!
Cindy
Cindy Curtis,RN,IBCLC
mailto:[log in to unmask]
http://www.erols.com/cindyrn
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Date: Mon, 20 Mar 2000 12:38:57 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: Pump sharing
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Jessica, I hear what you are saying about sharing pumps -- that too often it
is an excuse for not really thinking about what a pump costs, what its value
is, or whether this old used pump is the best answer for the mother involved.
At the same time, though, your post suggests to me a couple of follow up
questions. One is: how do you distinguish these cases from that of, say, a
Lactina rental that may have been through multiple users? Are rental pumps
made differently in some way that makes your problems with used PIS pumps not
a problem with rentals? I know that with a Lactina I have had to replace
some of the plastic parts that wear down and seem to decrease the pressure
after a while. I thought PIS parts were supposed to be more durable -- is
that not so? or do they wear down slower but can't be replaced? or what?
How old do they have to get before they are taken out of service and "the
newer model" brought in to replace them? (that is, how old relative to the
purchase-pumps you are describing?)
A second question might be, are these really concerns with pump sharing or
just with old pumps? To put it another way, why is an old PIS that she
bought from her friend who got it five years ago and used it for four kids
different from a PIS that this mom herself may have bought from you several
years ago, and since then used for multiple kids, stored in the basement,
etc? Would you also politely decline to help *that* mom sterilize her old
pump, just because you are entitled to get paid for your work after all; or
is there something specific to multiple mothers sharing that goes beyond old
and dirty to make this more of a problem?
I had been under the impression that part of the appeal of buying a PIS was
that it is durable -- that you buy it once and then can use it for as many
kids as you have, in contrast to rental charges that just keep adding up and
adding up with the passing months and years. Is this not really so? If
these pumps wear out or become problematic after a year or so, is that
something that manufacterers or dealers like you routinely make known to
purchasers at the time of sale? Otherwise it would be counter-intuitive to
many buyers, I think.
I am thinking of a couple of pairs of mothers I know who have shared PIS
pumps by passing them back and forth as they alternated babies. Mom #1 was
definitely planning to re-use the pump in two years for her second child; but
since she had a year off pumping after her first baby was a little older, she
was pregnant, etc, she meanwhile did her friend a favor and loaned the pump
to her for the in-between months. This pump was not as old, after all, than
it would be when Mom #1 got it back and used it again with her 2nd baby; it
had been stored badly for less time and cleaned more often because it was
never packed away in the dusty attic. How should these moms (and I) be
thinking about a) reuse by the same mom, and b) use in the same time frame by
another mom?
Any light you (or other pump dealers out there) can shed on this would be
informative. Thanks.
Elisheva Urbas in NYC
who has no financial interest in any pump company except for the large
investments in Medela equipment she has made already this lifetime and the
similar expenditure she sees coming up again, God willing, in her medium-term
future!
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Date: Mon, 20 Mar 2000 19:56:25 +0200
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: Pamela Morrison IBCLC <[log in to unmask]>
Subject: Weighing
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Heather, I know exactly what you mean, when you wrote, "mothers are
sometimes too scared to go to the clinic because they are worried about the
weighing...
I even felt it myself with my first two - even though I could see my
gorgeous babies were thriving and I knew bf was going well. The anxiety as
they were placed on the scales was acute".
A while ago I worked with a baby who wasn't thriving, so that the Clinic
Sister was wanting to weigh the baby frequently - about twice each week as I
recall. The mother was so unnerved by this that she would pop into my
office before each Clinic visit to weigh the baby on my scales. If the baby
had seemed to have gained she would keep the Clinic visit. If not, she
would call and delay the check-up another couple of days!! What does this
say about weighing? That it's not the *scales* which are the problem, but
the *person* behind the scales, whom the mother perceives to be making
unkind judgements which reflect badly on her mothering. Mostly, of course,
every mother is doing her level best - she just needs more help to identify
what the problem is for a slow-gaining or FTT baby.
Personally, I think weighing a baby is one really important measure we have
to assess whether he is doing well. Those numbers always tell a story. The
weight and the difference in weights over time warn us of a baby who needs a
bit more investigation or whose mother needs more specific help with
breastfeeding. They can be used to identify retrospectively when a problem
occurred, and so give a clue as to what needs to be changed now in order to
remedy it. On the other hand they can also be used to praise the mother
whose baby is gaining well, and make her feel really proud of her ability to
"successfully" breastfeed.
To me, the scales are a really useful tool and in antenatal classes and
working with new moms I strongly recommend weighing weekly for about the
first six weeks so that the baby's growth and food intake can be monitored
and any problems identified sooner, rather than later. Of course, not all
of them listen ......
Pamela Morrison IBCLC, Zimbabwe
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Date: Mon, 20 Mar 2000 13:40:34 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: Cleaning Pumps
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In a message dated 3/19/0 8:39:50 PM, Jan writes:
<< If any rental people are telling you they are actually sterilizing the
pumps,
they aren't telling you the truth, or they haven't a clue as to what
sterilization means. Clean it thoroughly? Yes. Absolutely. Sterilize?
Absolutely not. >>
Right.
I have been using the word "Sanitize", as more accurate, sounds good to
clients, conveying importance of and adherence to cleanliness standards -->
client confidence.
ie; For outpt use, pumps (the electric machines that are rented) are
"cleaned" by the renter prior to return, then "sanitized" by bf center staff.
For inpt use, pumps *should be* "sanitized" by staff between pts.
Debbie
Deborah Tobin
RN BSN IBCLC LCCE
Springfield, Virginia USA
In the suburbs outside the Washington DC beltway
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Date: Mon, 20 Mar 2000 13:44:43 EST
Reply-To: Lactation Information and Discussion
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From: Carol Brussel <[log in to unmask]>
Subject: bathing
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<< At least we are on the way... >>
pat, you mean at least "someone somewhere" is on the way. there was a
question recently about this relentless cord card issue, and a pediatrician i
know was nearby, and i said, oh, this cord thing is so silly. she replied in
an extremely determined way "oh, they can go septic SO FAST and DIE! you
would never say not to do the alcohol if you had seen that!"
and she didn't think it was the least bit amusing when i then suggested that
babies be kept in the hospital in isolation until the cord falls off, to
prevent such dire events, with constant cord care being done in the most
sterile of conditions.
some people just don't have a sense of humor.
carol brussel IBCLC
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Date: Tue, 21 Mar 2000 06:08:46 +1100
Reply-To: Lactation Information and Discussion
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From: Grant & Louise McLeod <[log in to unmask]>
Subject: tub baths more
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Reading more posts on tub baths I'll clarify that we don't "scrub" the =
baby as some of you describe! how horrible.
After birth the baby is wiped over so it keeps warm and first proper =
bath is usually the next day, using plain water, sorbolene or a soap =
free baby bath solution or a cake of soap - basically whatever will be =
used at home. A lot of women use a bath as an effective settling =
tecnique.( The baby will probably be bathed 2-3 times as our women stay =
4 days)
=20
Louise Dimmock McLeod
RN Midwife IBCLC
Meadowbank Australia
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"The cure for anything is salt water - sweat,tears or the sea"
Isak Dinesen
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Date: Mon, 20 Mar 2000 14:29:09 -0500
Reply-To: Lactation Information and Discussion
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From: Sharon Knorr <[log in to unmask]>
Subject: Re: Guava leaf remedy
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Dear Lori,
You might want to get ahold of the latest (April) issue of National=
Geographic which has a very interesting article about the use of local=
plants to treat disease in many societies. Malaria is mentioned several=
times. Although there does not seem to be any miracle cures, millions=
still die from it each year, there are local remedies which may either=
help to fight the disease, sometimes in conjunction with quinine, or to=
help the body's immune system cope with the presence of the parasite. In=
particular, in speaking of the use of Ayurveda - an ancient Indian healing=
system - "The treatment does not kill the parasite. The treatment seeks=
to restore the body's balance." Although many Indian children still die=
of the disease, many adults seem to live with it, getting ill only once in=
a while, probably when the immune system is stressed by other factors.=
Your friend should try to get as much up-to-date info as possible about=
the disease and presently known treatments so that she can put together a=
plan that can both boost her immunity while also being prepared to use=
whatever may be necessary should she become acutely ill.
Guava leaf is not mentioned in the article. I found it listed in only one=
of my herb reference books. It says that the leaves and bark can be=
brewed to use for treatment of indigestion or diarrhea. They are also=
used as part of a cough remedy in Ghana and can be chewed to relieve=
toothache. No references sited for any of this and no mention of active=
ingrediants or possible side effects. It is a member of the Myrtaceae=
family, genus Psidium.
Local doctors or healers would probably be the best source for information=
about whether it is used during pregnancy or lactation and whether they=
have seen any bad effects on mothers or babies. It will probably all be=
anecdotal, but that is all we have much of the time. Comes down to risk=
vs. benefit. Good luck. Malaria is a nasty disease and still remains a=
major cause of morbidity and mortality in many parts of the world.
Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
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Date: Mon, 20 Mar 2000 14:37:18 EST
Reply-To: Lactation Information and Discussion
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From: Carol Brussel <[log in to unmask]>
Subject: baths in hospital
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no, i don't work in a hospital but i have seen some baths in them. baby is in
the isolette and warmish water is slopped over him, scrubbed HARD with
phisohex soap, then wrapped in the thin blanket and taken over to the sink
where the water is turned on full blast and his head is stuck under it to
rinse him off. this is the general pattern of all the baths i have seen in
hospital.
and some people don't think i have any restraint. well, i never got arrested
for assault while watching any of this stuff.
carol brussel IBCLC
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Date: Mon, 20 Mar 2000 14:58:51 EST
Reply-To: Lactation Information and Discussion
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Here in the U.S., my experience has been that most moms are obsessed with
their babies' weights and are eager to have them weighed. I do breastfeeding
drop-in hours, one session concurrent with a mothers' support group.
Sometimes mothers in the support group hear I have a pump and come up
specifically to have their babies weighed, even when there is no concern.
In consults, I always weigh babies before feeds as part of my assessment.
Then, if it comes up during the feeding that there is some question, I can do
an after-feed weight. I've found that the times I don't, I wish I had.
Miriam Levitt RN, IBCLC
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Date: Mon, 20 Mar 2000 15:06:30 EST
Reply-To: Lactation Information and Discussion
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Subject: what's normal
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It seems to me that we're so far from anything normal in our childbirth
practices that the patterns of breastfeeding, weight gain, engorgement,
lactogenesis, etc., are difficult to assess.
A speaker at a conference once recounted her experiences travelling in Africa
and observing breastfeeding. She said that the babies are at the breast
almost constantly during the first day and the milk comes in around 24 hours.
Anyone have any experience to back this up? There are certainly many babies
I see who do not nurse at all in the first 24 hours, despite our best
efforts. On the other hand, the babies who are frantically hungry and
wanting to nurse "all the time" until the milk is in are a real challenge to
parents and staff. Part of it is cultural non-acceptance of this kind of
intense nursing, part of it the physical and psychological abilities of mom
who may have had a C-section, be sleep-deprived, etc.
I am constantly baffled by the differences I see in mothers' colostrum
production - ranging from nothing at all to be expressed by any means tried
(of course, hard to reassure mom, as I always do, that "it's really in there,
just keep pumping and the milk will come", no swallowing by baby despite
good attachment and suck - to babies who gulp at first feeding and moms who
can pump an ounce from day one!
In the discussion of when to initiate pumping, I think like most things there
are pluses and minuses and, also like most things, should be evaluated on an
individual basis. Some moms can't deal with pumping the first day, and it
would probably be detrimental to push it. Against this must be weighed what
I have observed - that some moms produce a copious supply despite terrible
beginnings, while with others it seems that if everything is not right from
day one, things never really take off properly. For these latter moms, early
pumping would be beneficial, but we don't know in advance which ones they are
going to be. Always an ongoing process of judgment, no hard and fast rules
that suit every case. Miriam Levitt RN, IBCLC
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Date: Mon, 20 Mar 2000 14:09:38 -0600
Reply-To: Lactation Information and Discussion
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From: Maurenne Griese <[log in to unmask]>
Subject: Mother's Milkmate
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Has anyone else on Lactnet been spammed by a sales representative selling
the above product via e-mail? I am wondering how these people get our
e-mail addresses. I often wonder if these people join Lactnet, harvest the
e-mail addresses and then un sub? Just curious...
Maurenne Griese, RNC, BSN, CCE, CBE
Manhattan, KS USA
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Date: Mon, 20 Mar 2000 21:51:48 +0100
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: Mother's Milkmate
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> Has anyone else on Lactnet been spammed by a sales representative selling
> the above product via e-mail? I am wondering how these people get our
> e-mail addresses. I often wonder if these people join Lactnet, harvest the
> e-mail addresses and then un sub? Just curious...
Haven't got any, but perhaps they're only targetting on the USA?
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
http://www.users.skynet.be/eurolac
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Date: Mon, 20 Mar 2000 16:48:38 EST
Reply-To: Lactation Information and Discussion
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Subject: baby bath
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Dear Friends:
Chris's post about when she refused a bath for her 3rd baby brought back
memories. I too refused to have my baby bathed, and got rolled eyes and sighs
and skepticism from the hospital staff. Fortunately, we went home 6 hours
after the delivery, so escaped further interaction.
As a nurse, I remember hearing other nurses complaining about families
that wanted to delay the bath. There was such an attitude of "we are the ones
that know what the right thing is to do" and "what's wrong with these people
who don't want to wash their baby?" in those situations. I sometimes went
along because I didn't know any better. There is an association of dirt with
anything coming out of that part of the body. What I did most of the time was
have the father give the first bath, with me watching.
It is only in the past decade or two that there is evidence (I mean
published studies) showing that babies track the breast by smell, and that
vernix protects the skin and helps keep the infant warm. All things I never
learned in my maternal-child health rotation, along with the lack of
breastfeeding information, value of skin-to-skin care, and infant feeding
cues.
Warmly, with sad memories of what I did from ignorance and good
intentions.
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: Mon, 20 Mar 2000 23:19:16 +0100
Reply-To: Lactation Information and Discussion
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: baby bath
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> It is only in the past decade or two that there is evidence (I mean
> published studies) showing that babies track the breast by smell, and that
> vernix protects the skin and helps keep the infant warm.
Not only protects the baby's skin: I've heard an older midwife tell, that she
and her collegues whenever possible used to take some of the vernix and rubbed
it onto their own hands and ensured anyone listening that there was no better
handcream!
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
http://www.users.skynet.be/eurolac
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Date: Mon, 20 Mar 2000 18:05:22 EST
Reply-To: Lactation Information and Discussion
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I am fascinated by all the posts on baths and how babies orient themselves to
self-attachment with the scent of amniotic fluid on their hands! Does anyone
know what this means for babies born in water? Will that kind of quick
rinsing interfere with the lingering scent (assuming it is plain, soap-free
water)? How does this relate to Leboyer's work?
Secondly, I wonder why these babies born on TLC's A Baby Story are *so*
bloody? I think one I saw today was born without an episiotomy - where did
all that blood come from? I'm no fan of hospital routines, but I wonder if
these baths are secondary to unusually messy births (compared to births over
intact perineums)?
Elaine Ziska
Jackson, MS
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Date: Tue, 21 Mar 2000 09:05:13 +1000
Reply-To: Lactation Information and Discussion
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From: Denise Fisher <[log in to unmask]>
Subject: sore nipples
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Re Helen's mother with the 4 week old baby who has very painful, damaged
nipples and has a previous history of this with other babies.
Another thing to consider here helen could be the baby's oral anatomy. I
think you did eliminate (lovely word!) tongue tie as cause, but perhaps it
may be a high palate or another tongue anomaly.
I've found palate shapes tend to run in families so when you mentioned
she'd had the same problems previously it waved red flags for me. Babies
with a high arch to their palate tend to flick the nipple up into the
'cavity' very easily, and have rarely experienced the nipple tip at the
junction of the soft and hard palate, therefore resisting it occuring.
The solution: ahh, if I only had it I'd be a wealthy woman!
Good latch is crucial here - and by good latch I mean brilliant latch.
There really needs to be so much breast tissue in the baby's mouth that the
nipple is forced further back, past the high palate to the correct junction
spot. Try all kinds of techniques to achieve this - be a lateral thinker.
Sometimes I get my best results by sitting the babe beside the mother so
that the chin is on the underside of the breast - gravity seems to help get
more breast tissue in like this; someitmes the mother leaning over the baby
works -again with gravity on her side.
Now you won't hear me say this very often - but a nipple shield may be
useful here. The baby isn't able to flick the formed shape into the arch
so easily.
If that is the problem really the only solution is a tincture of time. As
the baby's mouth grows he starts to take more breast tissue in anyway - and
I wonder if that palate assumes a better shape. I have assisted many
mothers who run the gamut of trying everything, then around 8 to 10 weeks
(often just after having the baby off the breast for quite some time to
allow healing) they come to see me - I help put the baby on the breast and
the feed is pain free for the first time ever. They think I'm a miracle
worker - but I'm not, I was just in the right spot at the right
developmental time. They go on to breastfeed happily - and it's often for
an extended time too - reluctant to wean I think after the difficulty
getting it started in the first place.
Now funny suck/tongue anomaly that's a suck training issue. I think I've
probably raved on long enough so will leave that unless you feel that is
specifically the problem.
Good luck
Denise
****************************************************
Denise Fisher, BN, RM, IBCLC
BreastEd Online Lactation Studies Course
http://www.breasted.com.au
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Date: Mon, 20 Mar 2000 23:28:59 +0000
Reply-To: Lactation Information and Discussion
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From: heather <[log in to unmask]>
Subject: Re: test weighing
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I accept that for some practitioners, test weighing is seen as a useful
'tool' alongside all the other things, and used appropriately, you feel it
can be valuable. But when you do test weights, those of you who do them,
what are you looking for? Are you comparing the difference you find
between before and after with a specified range of 'normals' or
'acceptables'? And how do you account for the fact that the weight of milk
does not reflect calorific value? And how do you extrapolate the intake
from that one feed to the intake over 24, 48, or whatever hours?
There are ways of seeing if a particular feed is typical in terms of
behaviour and 'feel' - just ask the mother about what happens the rest of
the time. But she can't tell you whether the calorie content felt
different, or the same.....
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
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Date: Mon, 20 Mar 2000 17:38:12 -0800
Reply-To: Lactation Information and Discussion
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From: Helen Armstrong <[log in to unmask]>
Subject: UNICEF/WHO medical reasons for supplementation
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Pam Morrison of Zimbabwe posted a quote from WHO/UNICEF training
materials:
"The l8 hour BFHI course (yellow manual, page 86) lists only seven
'Acceptable medical reasons for foods other than breastmilk' -
1) mother with active herpes lesion on breast/nipple
2) 3) and 4) all relate to HIV but stress that where the use of safe
alternatives to breastfeeding is not possible then breastfeeding
should continue to be the feeding method of choice,
5) mother who has severe psychosis, eclampsia or shock
6) mother who is taking cytotoxic, radioactive or anti-thyroid drugs
other than propylthiouracil and
7) mothers who specifically refuse to breastfeed."
I appreciate her making this material better known. However, it would
also be important to note the complementary list on page 80 of the
same manual, in the section on babies who need special attention.
[Please note that this manual was written in 1993; there are a few
bits of it we would reword or update in a newer edition.]
"Infants with medical conditions that do not permit exclusive
breastfeeding need to be seen and followed by a physician.
- Breastfeeding is not possible for a baby with galactosemia, because
he cannot tolerate the galactose in the breastmilk. This is a rare
condition, occurring in one out of 50,000 babies.
- Babies with other inborn errors of metabolism (e.g. PKU, MSU
disease) must be monitored for toxic serum metabolite levels for
possible adjustment in the management of breastfeeds.
- Babies with very low birth weight or who are born preterm, at less
than 1000g or 32 weeks GA may require supplementation.
- Supplementation may be necessary for babies with severe dysmaturity
with potentially severe hypoglycaemia, or who require therapy for
hypoglycaemia, and who do not imporve through increased breastfeeding
or by being given breastmilk.
- Babies with acute water loss may require water supplementation if
increased breastfeeding/breastmilk cannot provide adequate hydration."
However, lists are one thing and clinical management of the individual
baby is another, and more important. I salute the LactNet users who
are skilled at helping parents and health care providers come to a
reasoned arrangement for the care and breastfeeding of so many special
infants. Your accumulated wisdom on how to find a way around all
sorts of obstacles is an international resource!
Helen Armstrong, Consultant Infant Feeding & Care
Nutrition Section, UNICEF New York
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Date: Mon, 20 Mar 2000 19:09:45 EST
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From: [log in to unmask]
Subject: Ban on Breastpump advert
Comments: To: [log in to unmask]
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Subj: Several Stations, Including ABC, NBC, CBS, and Fox...
Date: 3/20/00 12:22:42 PM Eastern Standard Time
From: AOL News
BCC: DiaMichels
Several Stations, Including ABC, NBC, CBS, and Fox Affiliates, Ban
Advertisement Featuring Woman Pumping Breast Milk
MOUNTAIN VIEW, Calif.--(BUSINESS WIRE)--March 20, 2000--
WHAT: Epinions.com, the Web site where people post honest reviews on
more than 100,000 products and services, launched a television
advertising campaign on Monday, March 13, 2000 in major
metropolitan markets.
One of the ads features a woman using a portable breast pump
in her living room, while she reviews the product.
Several affiliate stations in these markets have either
declined to run the ad because it did not meet individual
station's standards, or pulled the ad based on viewer
feedback.
The following stations declined to run the advertisements
based on their standards: KIRO-TV (CBS) in Seattle; KGO-TV
(ABC) in San Francisco.
The following affiliate stations pulled the ad due to viewer
response:
-- WNYW-TV (FOX) in New York City
-- WNBC-TV (NBC) in New York City
-- KOMO-TV (ABC) in Seattle
-- WCVB-TV (ABC) in Boston
-- WHDH-TV (NBC) in Boston
-- KVUE-TV (ABC) in Austin
-- Time Warner Cable in Austin
-- UPN and WB Cable in Austin
VIEW THE AD AT: www.epinions.com/tvad-Breast-Pump
Epinions.com "Our ads show real people giving their opinions about
QUOTE: things they like and dislike. The ad campaign is
simply an extension of our site," said Mike Speiser,
co-founder of Epinions.com. "All people in the
Epinions.com ad campaign are real reviewers on the
site -- they are not actors. The spot featuring a woman
using a breast pump shows no body parts nor does it
contain profanity or violence. We find it unfortunate
that these stations decided to censor this ad. We
support the consumer's right to hear honest content
from real people."
LA LECHE "Our society needs to change how it looks at nursing
LEAGUE women. The breast was made to feed a nursing baby, not
QUOTE: to sell beer or other products as is often the case with
advertising,"said Kim Cavaliero, public relations
director for La Leche League International. "We believe
people shouldn't have a problem seeing a woman
breastfeeding her baby or using a breast pump to pump
milk for her child. In fact the American Academy of
Pediatrics recommends that all babies be breast fed
exclusively for the first six months of life and that
breastfeeding be continued through the first year or
until the baby weans itself naturally."
La Leche League International provides breastfeeding
information, support, and education to mothers who want
to breastfeed their babies.
CONTACT:
Alexander Ogilvy Public Relations
Ashley Hughes, 415/923-1660 ext. 136
or
Heather Buys, 415/923-1660 ext. 122
or
Epinions.com
Lauren Meller, 650/551-6608
Cell - 415/637-7075
or
La Leche League International
Kim Cavaliero, 847/519-7730 x 233
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Date: Tue, 21 Mar 2000 10:18:43 +1000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Denise Fisher <[log in to unmask]>
Subject: Carol's bathing experiences
Mime-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
Carol Brussel described bathing in hospital...
<snip> and some people don't think i have any restraint. well, i never got
arrested
for assault while watching any of this stuff. <snip>
If you had it would have been the wrong person arrested for assault!
I've tried hard not to get caught in this discussion - it not being
breastfeeding related (one of the list mothers is going to chat to us about
it soon...) but here I am:
We have just moved into a new unit (6 months). We don't bath babies in
birth suite at all. The parents often ask when baby will be bathed - it's
pretty laissez-faire when it happens - usually not until the next day
though. We've stopped using the perspex cot as the bath (as described by
Louise) WH&S didn't like the way we emptied them.
We now have a lovely big room with 2 very deep baby baths set into the
bench where the baths are done. (And the water isn't running at any stage
during the bath!) The whole family comes in to watch the first bath - must
be the most photographed room in the hospital. After that the parents bath
the baby whenever they want to, or not at all - mum ususally waiting for
dad to visit and they do it together, no staff.
The only other things in this room are three fantastically comfortable,
really well supporting rocking chairs for breastfeeding in. Most mothers
feed in their rooms, but at any time there is usually a mother or two there
feeding.
I hear what KD says about bathing and agree wholeheartedly. However, in
its defence, I remember feeling nauseated by the smell of blood on my first
born despite there not being any that I could wipe off - he wasn't bathed
until day 2. Also, if done with love and tenderness, the babies really do
love floating in the water and you can see them relax. And as Louise
mentioned it is a great tool for an unsettled babe - they relax in the bath
and will often have their best sleep of the day after it.
Quickly sending this off before KB says her bit ;-)
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, 21 Mar 2000 09:31:44 +1000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Virginia G Thorley <[log in to unmask]>
Subject: Re: Bf earlier in the century
Comments: To: [log in to unmask]
MIME-Version: 1.0
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Yes, Elisheva, the health workers and the substitute could never be wrong,
could they?! Only a mother's "deficient" body could be at fault. Stories
like these are sad - and infuriating. We can't help your grandmother or my
research subjects, but we can do our darndest to make a difference to the
new Mums we see.
Virginia
In sunny Brisbane, Queensland
----- Original Message -----
From: <[log in to unmask]>
To: <[log in to unmask]>; <[log in to unmask]>
Sent: Monday, March 20, 2000 4:22 PM
Subject: Bf earlier in the century
> Virginia wrote about mothers in the 1940s who couldn't let down before
their
> babies were whisked away by the clock watchers.
>
> My husband's grandmother, now 87, had in a way the opposite experience
when
> her first child was born in Boston in the 1930s. She had "plenty of milk
but
> my milk was too thin, it wasn't rich enough" so that the baby "had colic"
and
> didn't gain weight.
>
> My theory of this now is that the mother was engorged, the baby only
allowed
> to stay at the breast long enough to take off a little of the copious
> foremilk, and the result was a nasty lack of hind milk.
>
> Leading of course to the same result -- the saving power of infant formula
:(.
>
> Elisheva Urbas, NYC
>
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Date: Mon, 20 Mar 2000 16:44:55 -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: Re: Slippery Elm, colic, burning off alcohol
Comments: To: gima <[log in to unmask]>
Mime-version: 1.0
Content-type: text/plain; charset="US-ASCII"
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Pat: Please pass my response below on to the person requesting info:
> Hi Pat, A Mennonite mom has just called me and asked about giving 5 drops
> of Slippery Elm to her 3mo every 2 hrs. She is to give it before the
> nursings. It has 50% grain alcohol in it. I remember you saying once about
> "burning it off". Can you e-mail me how to do this. Also do you know
> anything about this herb? The midwife told her it helps with colic. Thanks,
> Mary Ann
Mary Ann:
To burn off the alcohol, have mom heat small amount (a few table spoons) of
water till it's steaming (this is easier done with a large amount and then
take out a table spoon or two). Immediately put a few days worth of dosage
into the clean, freshly boiled water and the alcohol with steam out. Once
cooled, mix thoroughly by shaking and take out 5 drops. You didn't say
whether this is a direct herb tincture or a homeopathic. This works with
either. Believe it or not, with homeopathic principles this will make the
dosage stronger.
Slipper Elm is traditionally used for digestive disorders. It is a
"demulcent and nutritive astringent." With babies, I use a combo
homeopathic called "colic" by Nature's Sunshine Products. It has
peppermint, bitter apple, and rhubarb or straight teas of chamomille and
fennel. The slipplery elm is targeting only one type of colic--intestinal.
If this is the case, then mom should also be taught infant massage to move
the intestines (up from the right hip, across the mid/upper ab, and down the
left side to the left hip). The other preparations that I've had success
with are Hyland's Homeopathic's for colic (but in a lactose base derived
from cow) and Distress Remedy (NSP in glycerine base) or Rescue Remedy (must
burn off the alcohol if this is a concern).
Good luck!
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
>
> Mailto:[log in to unmask]
>
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Date: Mon, 20 Mar 2000 19:55:01 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Beth Collins <[log in to unmask]>
Subject: Mothers milk tea and contraindications for premies
I had a recent call from a mom who was told not to take mothers milk tea to
improve her milk supply because it isn't approved for use with premies. I
had recommended it to help increase her supply. Now she is afraid to take
it. The nurse in the NICU told her that she read it on the net. The mom
is already doing all the other things to increase supply. double pumping
hospital grade pump, hydration. She has returned to work and has a super
premie in the NICU. It was a twin birth with the other infant not
surviving, SO this mom is very reluctant to take anything that might cause
harm to her baby.
So the question is have any of you heard that mothers milk tea shouldn't be
used with premies?
Thanks
Beth Collins RN,IBCLC
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Date: Mon, 20 Mar 2000 18:58:09 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: Kathy Dettwyler <[log in to unmask]>
Subject: baths
Mime-Version: 1.0
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We've discussed bathing before on LactNet. When Alex was born, I walked the
halls of the hospital in labor and watched poor little Kolton Kubin get
scrubbed head to foot for 10 minutes with a NAIL BRUSH under running water.
He was newborn, bright red, and screaming his head off. That's why I didn't
let the nurses give my son a bath.
Kathy Dettwyler
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Date: Mon, 20 Mar 2000 18:58:05 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Kathy Dettwyler <[log in to unmask]>
Subject: Malaria
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> Although many Indian children still die=
> of the disease, many adults seem to live with it, getting ill only once in=
> a while, probably when the immune system is stressed by other factors.
Adults who "live with malaria" can do so because they have developed
cell-mediated immunity to it by surviving numerous bouts during childhood.
If you grow up in a non-malarial area and move to a malarial region as an
adult, chances are you will die before your body can develop cell-mediated
immunity, as this works best in children. As you age into your 60s and 70s,
you lose your cell-mediated immunity to malaria, such that many old people
die of malaria, as well as many infants and children under 5. If you look
at a mortality rate curve by age, it forms a big wide flat-bottomed U --
high in the beginning of life, high in old age, very low in the middle.
Adults in malarial-ridden areas HAVE malarial parasites all the time, but
their immunity usually keeps the parasite levels below symptomatic levels.
The same is true of quinine-derived drugs -- they don't *prevent* you from
getting malaria, they merely keep the number of parasites below symptomatic
levels. Infection with the parasite is probably universal in much of the
world, but having the frank "disease" is rare among older children and
adults. It is my understanding that when a native adult gets symptomatic
malaria it is usually because (1) he has been infected with several
different strains at once or (2) his nutritional status has improved
somewhat -- malarial parasites thrive best in well-nourished people, and
don't fare very well in malnourished ones.
A typical course of malaria for an adult Malian (West Africa) is to have
fever and headache for 2-3 days, and then be fine again. There are many
dietary treatments for malaria in different cultures around the world.
Kathy Dettwyler
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Date: Mon, 20 Mar 2000 20:24:12 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: Going no mail
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Content-Type: text/plain; charset="US-ASCII"
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Its that time.
I'm so busy nesting that I cant keep up. Am going no mail until after the
baby. If anyone needs to reach me please e-mail me privately.
Cheryl Tompkins CLC
Phoenix AZ USA
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Date: Mon, 20 Mar 2000 20:40:13 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: "We know better..."
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Nikki says,
<< As a nurse, I remember hearing other nurses complaining about families
that wanted to delay the bath. There was such an attitude of "we are the ones
that know what the right thing is to do" and "what's wrong with these people
who don't want to wash their baby? >>
Yea, but isn't this the attitude about anything that goes against the
cultural norm -- whatever that "norm" is in that particular hospital? I got
it for wanting a home birth. Moms get it if they want to breastfeed and keep
their babies in bed with them. Parents get it if they choose to not: (pick
one -- vaccinate/circumcise/birth in a hospital/start solids at 5
months/whatever).
It's the way....walk ye in it.
Jan -- who is STILL cynical in Wheaton, and it is yo these many hours later!
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Date: Mon, 20 Mar 2000 20:46:14 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: test weighing
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Heather asks,
<< There are ways of seeing if a particular feed is typical in terms of
behaviour and 'feel' - just ask the mother about what happens the rest of
the time. But she can't tell you whether the calorie content felt
different, or the same..... >>
That's right -- you are right on, there, Heather. But if a mom transfers
only, lets say, 12 ml on day 7, even if the milk is 30 cal/ounce, that
translates into only 12 calories for that feed. Not enough in my book,
especially if punkin is only nursing 8 to 9 times a day, and in this case,
hasn't breastfed for 2.5 hours or thereabouts. I do try to take all that
into consideration when I'm looking at a baby that is (a) constantly fussy
off the breast, and (b) isn't gaining weight and/or (c) has < 3 stools/24
hours under 5 weeks (or so) of age.
So yes, I am considering all of that....
Jan
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Date: Mon, 20 Mar 2000 20:50:00 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Julius Edlavitch <[log in to unmask]>
Subject: LACTANCIA MATERNA PROLONGADA
Mime-Version: 1.0
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Estimados Listeros:
El sabado antepasado hemos hecho un chat de prueba y al probar la opcion=20
webtour algunos usuarios han tenido dificultades. para ello utilizaremos,=20
la opcion JAVA CHAT.
****************************************************************************=
=20
**************************************************************************
Sabado 25 de Marzo del 2000
3 Pm de Argentina , 1 Pm de NY
Sesion de Lactancia Materna Coordinada por la Licenciada Monica Tessone
LACTANCIA MATERNA PROLONGADA
****************************************************************************=
=20
****************************************************************************
INSTRUCCIONES
1) Direccion www.pedschat.org
2) Aquellos que no estan registrados rogamos hacerlos en el formulario=20
clickeando la opcion REGISTER NOW
3) Para ingresar al canal de CHAT hacerlo clickeando la opcion ENTER CHAT=
ROOM
4) Si tiene dificultad en el idioma Ingles puede clickear la siguiente=20
direccion y encontrara en espa=F1ol el instructivo y los link de ingreso=20
http://www.pedschat.org/latinos/spanish.htm o bien www.api.org.ar en la=20
opcion de LINKS de docencia
5) Aquellos que han tenido dificultad para conectarse por favor envienme un=
=20
E-mail con el inconveniente que tuvieron que les respondere a la brevedad.
Saludos
Walter Javier Juarez -MD
Coordinador de las Sesiones en Espa=F1ol
INTERNATIONAL PEDIATRICS CHAT
www.pedschat.org
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Date: Sun, 19 Mar 2000 18:53:01 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: "A. Allen Hulse MCP" <[log in to unmask]>
Subject: Re: need a local LC
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Hi! If you don't hear from anyone directly, I can send you names of
L.C.'s at Yakima Memorial and Providence Yakima. Also there is La Leche
League for support in Yakima Valley. Call Traci at (509) 965-0861.
Best wishes!
Judy Hulse, RN, IBCLC Lynnwood, WA WALC & LLL Leader.
[log in to unmask]
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Date: Mon, 20 Mar 2000 21:45:37 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: "L-Soft list server at PEACH.EASE.LSOFT.COM (1.8d) (by way of
Kathleen Bruce <[log in to unmask]>)"
<[log in to unmask]>
Subject: File: "LACTNET LIST"
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FYI. These are the countries currently listed as picked up from our listserv
command. If you don't see your country, please let me know. I think there
are a few that don't show up. David B., let me know.
Thanks.
Kathleen
*
* Country Subscribers
* ------- -----------
* Argentina 3
* Australia 102
* Austria 3
* Belgium 1
* Brazil 2
* Canada 93
* Chile 1
* Costa Rica 3
* Dominican Republic 1
* Fiji 1
* Finland 3
* France 5
* Germany 8
* Great Britain 14
* Hong Kong 1
* Indonesia 1
* Ireland 3
* Israel 31
* Italy 4
* Japan 1
* Malaysia 1
* Mexico 1
* Micronesia, Federal States of 2
* Netherlands 13
* New Zealand 17
* Norway 3
* Peru 1
* Philippines 1
* Singapore 5
* South Africa 4
* Spain 2
* Sweden 4
* Switzerland 3
* Taiwan 1
* Thailand 1
* USA 2,263
* Zimbabwe 2
*
* Total number of "concealed" subscribers: 31
* Total number of users subscribed to the list: 2605 (non-"concealed" only)
* Total number of countries represented: 37 (non-"concealed" only)
* Total number of local host users on the list: 0 (non-"concealed" only)
*
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Date: Mon, 20 Mar 2000 18:55:26 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: maka laughingwolf <[log in to unmask]>
Subject: thanks, looks like no surgery after all!
Comments: To: radicalbreastfeeding <[log in to unmask]>
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thanks to everyone for their suggestions and prayers, thoughts...
i have apparently ovulated for the first time since griffin was born, as =
evidenced by a probable ovarian cyst. i've had many, but this one hurt =
more than most, and i was really concerned about an ectopic pregnancy. i =
had a tubal pregnancy 2 years ago and hemorrhaged badly before it was =
finally discovered (didn't show up on ultrasound, exploratory surgery =
found "an unbelieveable amount" (per my GYN) of blood in my abdomen). i =
had decided this morning that if the pain was the same or worse by this =
evening i'd go to the doctor tomorrow. it peaked early this morning, =
being almost unbearable at that point, and by afternoon it was gone, =
with just some residual tenderness left now. also, lots of yellow watery =
discharge today. so from past experience i'd say that the cyst ruptured =
in the night.
i was so scared of having to go through surgery and hospitalization, =
which i hate anyway, while trying to fight to breastfeed griffin.
Maka Laughingwolf, nursing CONSTANTLY for 48 hours...Griffin is =
teething, having a growth spurt, fighting a cold, AND recovering from 6 =
days in the car, ALL AT ONCE!!!
breastfeeding peer counselor
studying toward eventual IBCLC
***NOMAIL on LACTNET***
settling into our new (temporary) home in Yakima, WA
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Date: Mon, 20 Mar 2000 22:01:42 -0500
Reply-To: Lactation Information and Discussion
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From: Patrica Young <[log in to unmask]>
Subject: Re: baths
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There is also the issue of HIV and universal precautions. I believe until
baby is bathed nurses must wear gloves to handle baby. Sincerely, Pat
in SNJ
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Date: Mon, 20 Mar 2000 21:19:15 -0600
Reply-To: Lactation Information and Discussion
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From: Bonnie <[log in to unmask]>
Subject: Tub baths....
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I must say I am enjoying the discussion on tub baths, and the different =
views are food for thought.
At the hospital where I am employed, we have been tub bathing our =
newborns for at least 12 years. When I first began working there I =
thought the sponge bath was the way to do it. Our babies are routinely =
taken to the triage nursery anywhere from immediately after birth =
(depending on mom's or babe's condition) to two hours post delivery. =
There, they are placed on an open ohio to warm and await their first =
bath. Many of our SVD's go home at 48hrs but when they were staying on =
average 4 days several years ago, it was routine to do a baby bath =
demonstration for the new mom and have her do a return demo the =
following day. Now due to cut backs, and a heavier patient assignment =
and shorter hosp. stay, we have a video we show them on the tub bath =
(yes, cord and all into the water) and maybe on a good day they have the =
opportunity to do the bath themselves before they leave the hosp. =
Needless to say, many grandma's are shocked!! that we put those baby's =
into the water. As for the alcohol to the cord...we discontinued that 2 =
years ago based on the research done showing alcohol removed the norm. =
bacteria that facilitates cord separation. Again, we have shocked =
grandma's....but how do we keep the cord clean? Dry Q-tip around the =
base 4 times a day, and teach the parents to obs. the cord for what's =
norm. =20
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Date: Mon, 20 Mar 2000 21:23:29 -0600
Reply-To: Lactation Information and Discussion
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From: Bonnie <[log in to unmask]>
Subject: Tub baths
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Sorry for this, but I keep forgetting to sign my posts...so bonniemc is =
from Bonnie RN IBCLC, Winnipeg Manitoba, Canada where spring is here, at =
least for the next week until the next snowstorm rolls in.
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Date: Mon, 20 Mar 2000 20:07:44 -0800
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: water-births and baths
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While I haven't had the pleasure of having any of my children in water, I
have attended several births in water. Some of them were in a very big
hurry to get baby to surface; others were quite casual and let baby "breathe
in the bath water" as long as cord was still pulsing (yes, this can be
nerve-racking). In all cases though, the vernix provided a "turtle shell
wax" that left water beading and running off the body. If no scrubbing or
soap is used, the vernix remains intact. Remember that for 40 weeks give or
take, baby has been in an aqueous solution in which the vernix has protected
him/her.
I suspect that just as new cosmetics are promoting "colostrum" (bovine) to
enhance skin youthfulness, someday we may see vernix hand cream:) There are
many practices, such as keeping placentas and making "placenta prints", that
many hospital staff and the women who birth there would cringe at. However,
I find these ritualistic practices to be most fascinating from a cultural
perspective (maybe I should have been an anthropologist, Kathy?)
Warmly,
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Mon, 20 Mar 2000 20:13:41 -0800
Reply-To: Lactation Information and Discussion
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: bathing IS bf related
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Denise: I have to say that my take on this is that bathing IS most
certainly bf related and that is why the list-moms have stayed quiet. If
one looks at Klaus and Klaus's research on the washing of the amniotic fluid
off the hands impairing bf, how can one not see this as a bf issue? When
baths take place away from the mother, the issue is further confounded by
the separation of m-b dyad (yes this does still happen). Last, we've spoken
about how bathing reduces babies' instincts but I hypothesize that the
bathing decreases the mother's olfactory response to baby and perhaps
impairs bonding. No, I haven't a single published article to prove this
last point, but I'd love to hear of one. 'Just my 2 cents.
Happy Spring!
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Mon, 20 Mar 2000 20:22:15 -0800
Reply-To: Lactation Information and Discussion
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: mother's milk tea
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Beth: The last time I looked, Mother's Milk Tea had peppermint as it major
component. Mint actually surpresses lactation (sage and mint are related).
I never recommend this tea, in spite of the fact that red raspberry is
beneficial. In addition, teas have very unpredictable potency. If one is
trying to increase milk supply, using specific potency capsules of herbs
such as fennugreek, hops, thistle, etc. is a means far more easily
controlled and dosage can be increased accordingly (it is critical that your
herb supplier guarantee freshness, lack of pesticide & fungicide residue and
potency because this is one of the major problems with herbs in the US).
I have found that most people don't realize that one should start patients
off on low dose 450 mg capsules twice a day and work up to as many as 3-4
capsules TID or QID to get the full effect (Yup, that's a lot of capsules).
Some moms don't need more than 2 TID, but many won't show improvement until
they get up to the higher dose.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Tue, 21 Mar 2000 11:26:27 +1000
Reply-To: Lactation Information and Discussion
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From: Virginia G Thorley <[log in to unmask]>
Subject: Cute little hands & kneading
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Paula,
I haven't seen the thread on "kneading". However, it is something I =
discuss regularly with my Mums. Here's why:
Some years ago I had a Mum whose baby used to head-butt the breast =
some minutes into a feed. She asked me why, and I explained that this =
is what I've observed calves and goat kids doing, to bring another =
let-down (MER).
As head-butting isn't a common behaviour in human babies, that set =
me thinking about what human babies do, to achieve the same purpose. =
Observation indicated that they soon learned to press in with their =
little fists --> Mum looked down at the touch and saw the cute little =
hand --> she had a let down (MER) --> the baby started drinking again.
If a Mum is nervous or not letting down, I take the baby's hand =
(with permission) and place it on her breast, and apply gentle pressure, =
just enough for her to be aware fo it. The above scenario usually =
follows. I then explain. Even when the mother is conscious of the =
above, it still seems to work. If her baby has figured out this way of =
"priming the pump" for herself/himself, I talk about how clever s/he is, =
already. The mother smiles about how clever her tiny baby is - and =
"whoosh" goes her MER.
All the above is based on very many observations. Wrtiing this, I =
wish I had recorded my observations and made a study of it, instead of =
just applying them.
When I read the word "kneading" it took me a few moments to work =
out what you meant, Paula. I'd describe the more vigorous efforts as =
"kneading", but often it is a more gentle action.
Virginia
=20
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Date: Tue, 21 Mar 2000 12:01:14 +1000
Reply-To: Lactation Information and Discussion
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From: Virginia G Thorley <[log in to unmask]>
Subject: Fw: Bf earlier in the century
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Yes, Elisheva, the health workers and the substitute could never be wrong,
could they?! Only a mother's "deficient" body could be at fault. Stories
like these are sad - and infuriating. We can't help your grandmother or my
research subjects, but we can do our darndest to make a difference to the
new Mums we see.
Virginia
In sunny Brisbane, Queensland
( o )( o )
This is not a substitute
_________________________________________
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Date: Tue, 21 Mar 2000 12:50:03 +1000
Reply-To: Lactation Information and Discussion
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From: Virginia G Thorley <[log in to unmask]>
Subject: Dental caries
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Pam, perhaps we could add this to that list: mouth kissing by someone =
with dental caries, transferring the bacteria.
Virginia =20
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Date: Tue, 21 Mar 2000 13:23:05 +1000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Virginia G Thorley <[log in to unmask]>
Subject: Old antifungals - Whitfield's ointment
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One of the two references provided by Amy mentioned Whitfield's =
ointment. I haven't seen it round lately (mind you, I haven't been =
looking). It was effective on puppies as well as children, for =
ringworm. Does anyone know what's in it?
Virginia
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Date: Tue, 21 Mar 2000 00:12:29 -0800
Reply-To: Lactation Information and Discussion
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From: Ann Calandro <[log in to unmask]>
Subject: Test Weighing
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I understand both sides of this issue, but I wanted to share a story that
happened today.
Mother of 4 day old 34 week baby girl (4 lb-7 oz) is rooming in with her.
Kangarooing between feeds. Baby has nursed well since birth, has had no
bottles or formula, just her mother's milk. A few times when she was sleepy
and wouldn't nurse, her mom pumped colostrum and gave it to her with a
dropper.
The nurse today was upset because the little one was only nursing for ten
minutes and that "was NOT enough". Mom said her milk flowed rapidly and she
felt baby was just full in ten minutes. So in order to prove to the nurse
that the baby was taking in sufficient milk, we did test weights a few times
on my office gram scale, which I left in mom's room. The first time, the
baby latched and nursed about 6 minutes and would take no more. Amount
taken in- 54cc. The second time the baby nursed a little longer, about 10
minutes. Amount taken in- 68 cc. The nurse practitioner told the nurse to
let up on the mom, the baby was doing wonderfully and didn't have to nurse
any longer than she wanted to!
This time the scale was helpful. The mom feels more comfortable with the
baby's intake. The HCP is happy!
The nurse has learned something as well.
Ann Calandro,RNC,IBCLC
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Date: Tue, 21 Mar 2000 16:37:35 +1000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Virginia G Thorley <[log in to unmask]>
Subject: Mother;s milk tea
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To Beth Collins:
"Mother's milk tea" can mean many things, depending on place, =
manufacturer, and so on. What concerns me is that they are *blends* and =
so the mother is not ingesting just one herbal medication. Several =
years ago Rosti et al reported two cases, in Italy, of mothers whose =
breastfeeding was dramatically undermined by taking copious amounts of a =
"mother's milk tea". It made the babies two lethargic to feed, and they =
only recovered when it cleared their systems. The two references, =
below, are for the Rosti article and my short discussion of the four =
ingredients of the tea (with further references):
=20
1. Rosti L, Nardini A, Bettinelli ME, at al. Toxic effects of a herbal =
tea mixture in two mewborns. Acta Paediatrica 1994; 83:683.
2. Thorley V. (letter) Breastfeeding Review 1996: 4(2):82.
Isn't it more important to educate and encourage mothers and their =
support persons that good brestfeeding management will do more for their =
supplies than these teas? (Yes, I know, that takes time, they need the =
placebo effect of doing smething they believe in, etc, etc ....)
Virginia
In cloudy Brisbnae, Queensland
( o )( o )
This is not a substitute.
____________________________________________________
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Date: Tue, 21 Mar 2000 16:47:45 +1000
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From: Virginia G Thorley <[log in to unmask]>
Subject: Bathing, hazards of
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To Kathy Dettwyler:
The bright red baby reminded me of two babies who were mentioned =
by a respondent in my study of postwar Mums. They were bathed soon =
after delivery, by a nurse who didn't test the temperature of the water. =
One poor little newborn received full skin thickness burns. The mother =
of the other considered herself lucky - her newborn was "only" bright =
red! This was in the context of a severe staff shortage at the time, a =
lack of senior staff (which meant there often wasn't time for =
on-the-ward training of junior staff or assistants), and the postwar =
baby boom.
I suspect that Mums may be more careful of their own precious =
babies, and not in such a hurry.
Virginia
( o )( o )
This is not a substitute.
_______________________________________________
=20
=20
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Date: Tue, 21 Mar 2000 09:17:30 +0100
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: test weighing
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About the testweighing I'd like to add that it can make moms that anxious that
they will actually have a limited MER and per saldo have less milk as a *result*
of weighing pre and post feed. At the other hand: if done well, with the right
intention and combined with good education about it to the mother it can be a
valuable *extra* tool in determining wether the baby is receiving enough
nourishment.
Paula Meier did some research on estimated vs weighed intake at the breast (J
Hum Lact 19(3):163-68; 1994). From her conclusion: ''The data support maternal
perceptions about being unable to use clinical cues accurately in the post
discharge period to determine wether infants are ''getting enough'' milk by
breastfeeding alone.'' Meier did study preterme babies' intake here, so it
might not be so for fullterms babies' mothers, but it did amaze me that both
investigators' as well as mothers' estimate of babies' intake at the breast
could be way above or below weighed intake.
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
http://www.users.skynet.be/eurolac
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Date: Tue, 21 Mar 2000 10:44:08 +0100
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From: Rachel e-mail <[log in to unmask]>
Subject: bathing babies
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I was no mail for 5 days and have obviously missed something.
Where I work, we wash blood and gunk off newborns in plain water about =
two hours after birth if they have normal body temperature. The bathtub =
is a large sink which is part of the same countertop where babies are =
clothed, under a warming lamp, before being transferred to postnatal =
ward. If they are a bit lower in temperature we just wipe blood off =
them with a warm washcloth. We use oil in the water if the baby is post =
dates and peeling. There is never any scrubbing but babies with lots of =
hair, which acts as a gunk collector, may have their hair combed with a =
de-lousing comb under running, comfortably warm, water. Most Norwegians =
don't find blood stains on clothes, or globs of bloody mucus on the =
baby's head to be esthetically acceptable, it's just one of our cultural =
peculiarities, I guess, and one which immigrant groups seem to recognize =
as well.
On the ward, mothers and fathers bathe their own babies for all their =
enjoyment, but not more than once a day! They usually appreciate having =
staff present for the first bath to help if need be, and after that they =
do it themselves. This is often a photo/video opportunity and siblings =
may participate. It happens in our nursery, which is used only for =
changing and bathing babies and is the domain of parents, babies and =
staff. Again, we use water with or without oil, no disinfectants and no =
special agents on the cord. We do wipe carefully around the cord to =
remove, well, gunk. We have a word as technical as toe-jam for it, and =
treat it about as technically too. Mothers are very often squeamish =
about this and love it if we offer to do it. They seem to be worried =
that the baby is like a balloon and the cord stump is where it is tied =
to keep the air in.
Mothers sometimes shower while father bathes baby in the birth room. =
This is at the end of the two hours they spend just getting to know each =
other. I feel we have many other routines which are more detrimental to =
BF than our bathing practices, and even so, you know what our stats are =
like!
just my 0.25 worth
Rachel Myr
[log in to unmask]
Kristiansand, Norway where our system looks SUPER high tech after my =
visit to Amsterdam last week. Our BF stats are still miles better than =
theirs-- more and longer.
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Date: Mon, 20 Mar 2000 11:34:44 +0200
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From: Jean Ridler <[log in to unmask]>
Subject: Re: tub baths?
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Maybe I'm missing something obvious here, but exactly how are babies bathed
in the US before the cord comes off? What is meant by a "tub bath"? To
relate this to breastfeeding - if the baby has to be bathed in the nursery
that interferes with rooming-in and baby-friendliness.
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Date: Tue, 21 Mar 2000 06:43:54 -0500
Reply-To: Lactation Information and Discussion
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From: Patrica Young <[log in to unmask]>
Subject: Re: mother's milk tea
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>I have found that most people don't realize that one should start patients
> off on low dose 450 mg capsules twice a day and work up to as many as 3-4
> capsules TID or QID to get the full effect (Yup, that's a lot of
capsules).
> Some moms don't need more than 2 TID, but many won't show improvement
until
> they get up to the higher dose.
Chris, are you referring to herbs in general or a specific one here?
Thanks, Pat in SNJ
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Date: Tue, 21 Mar 2000 06:48:18 -0500
Reply-To: Lactation Information and Discussion
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From: Patrica Young <[log in to unmask]>
Subject: Re: tub baths?
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I think in my area (Southern New Jersey- east coast USA) most babies get
what would be described as a sponge bath - no immersion - until the cord
comes off. Blue dye or alcohol to cord is still routine. Sincerely, Pat
in SNJ
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Date: Tue, 21 Mar 2000 12:55:58 +0100
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: bathing babies
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Rachel Myr, Kristiansand, Norway where our system looks SUPER high tech after my
visit to Amsterdam last week. Our BF stats are still miles better than theirs--
more and longer
Welcome back, Rachel. Yes it is harsh that with all this great midwifery
practice and birth care system there is no positive effect on breastfeeding. But
that is a living proof that not only settings, but above all knowledge and
attitude of the persons attending the new mom and baby that determine the
incidence and duration of breastfeeding. Dutch midwifes and neonatal caretakers
could learn an awfull lot if they'd return your visit and go to Norway!
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium, just across the Dutch border.
http://www.users.skynet.be/eurolac
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Date: Tue, 21 Mar 2000 07:32:45 EST
Reply-To: Lactation Information and Discussion
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Subject: Bathing...mittens...bonding...breastfeeding
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Chris said,
<< . If
one looks at Klaus and Klaus's research on the washing of the amniotic fluid
off the hands impairing bf, how can one not see this as a bf issue? When
baths take place away from the mother, the issue is further confounded by
the separation of m-b dyad (yes this does still happen). Last, we've spoken
about how bathing reduces babies' instincts but I hypothesize that the
bathing decreases the mother's olfactory response to baby and perhaps
impairs bonding. >>
And last week Diane commented on the use of mittens on the baby and some
babies not being able to latch on well....I wonder if the same process is
going on here. Not only do we bathe the baby, but then we put long sleeve
shirts on with mittens so she doesn't scratch herself, and bundle her in a
blanket. The mother showers, uses deodorant and becomes a totally different
person than she was in the birthing room. I wonder how much that plays into
our difficulties in getting babies to the breast AFTER they've nursed in L&D?
In our hospital, they do a palm print of the baby for ID purposes, so of
COURSE the hand is scrubbed clean of the black ink. Most times, though not
always, this is done before the baby is put to breast in L&D. (You know,
eye-dropped, bundled, hatted, palm-printed, examined, blah blah -- must get
those things done before mom can breastfeed...)
No studies -- just some musings to tag along with Chris & Diane.
Jan B in Wheaton
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Date: Tue, 21 Mar 2000 07:37:55 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Kathy Rubin <[log in to unmask]>
Subject: Philippines trip
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Hello All--
I am back from my medical mission to the Philippines and altho I was not able
to connect with any LCs or LLL leaders in the area where I was, I did meet
many bf moms and babies. The mission was with a group called Operation Smile
who does surgeries on kids with cleft lips/palates.
The greatest thing I saw (other than the patients and families being
grateful for their surgeries) was moms breastfeeding their babies who had
been born with cleft deformities....I guess no one told them that they
couldn't!! and with limited options (limited refrig and money) breastfeeding
was just the "done thing".
What we could learn from this!!!
Kathy Rubin IBCLC RNC APNC in NJ
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Date: Tue, 21 Mar 2000 08:09:13 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: gima <[log in to unmask]>
Subject: Re: Philippines trip
In-Reply-To: <[log in to unmask]>
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> The greatest thing I saw (other than the patients and families being
>grateful for their surgeries) was moms breastfeeding their babies who had
>been born with cleft deformities....I guess no one told them that they
>couldn't!! and with limited options (limited refrig and money) breastfeeding
>was just the "done thing".
Kathy, please tell us more!!
Pat Gima, IBCLC
Milwaukee, Wisconsin
Mailto:[log in to unmask]
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Date: Tue, 21 Mar 2000 09:32:40 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: "David W. Vaklyes" <[log in to unmask]>
Subject: Re: Ban on Breastpump advert
In-Reply-To: <[log in to unmask]>
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The correct link to the ad is:
<http://www.epinions.com/tvad-Breast_Pump>
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Date: Tue, 21 Mar 2000 07:53:55 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Linda J. Smith" <[log in to unmask]>
Subject: FW: Important article
Comments: To: "CIMS council 2000 (E-mail)" <[log in to unmask]>,
"CIMS Listserve (E-mail)" <[log in to unmask]>
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FYI -
From: [log in to unmask] [mailto:[log in to unmask]]
Sent: Tuesday, March 21, 2000 9:32 AM
To: [log in to unmask]
Subject: Important article
Hi Linda:
I'm currently on "no mail" for Lactnet but I think this is a very poignant
article about how one woman can change the system when she's doing it for
her child. You won't believe how the system has changed in just one year
because one woman was brave enough to be assertive in a place where that can
get you in more trouble.
The reason I'd like to share it is that I think it may be used as an example
by LCs and other perinatal care providers working on this issue in other
USA states or other countries. For others it may provide an impetus to look
at their state's/country's policy/procedure re: mother-baby separation when
a mother is incarcerated.
http://enquirer.com/editions/2000/03/21/loc_prison_moms_fight.html
Karen
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Date: Tue, 21 Mar 2000 10:14:44 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: ten minutes
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Ann relayed a story, which included this line:
<< The nurse today was upset because the little one was only nursing for ten
minutes and that "was NOT enough". >>
Another hot button pushed....and just when was the last time someone said to
the nurse, "I'm sorry, but you've only eaten for 7 minutes. It doesn't count
unless you eat for 22." We don't time ANYONE else! Why this emphasis on
being on the breast for x number of minutes. And suppose the baby was on the
breast for 20 minutes, but was only drinking for 6 and hanging out for 14. I
suppose the nurse would have been happy because the baby fulfilled the
requirement...or, would 20 minutes have been too long?
Jan B -- clock stomper in Wheaton
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Date: Tue, 21 Mar 2000 10:22:21 -0500
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<[log in to unmask]>
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From: Becky Flora <[log in to unmask]>
Subject: tingling sensations in legs only when breastfeeding; REPOST
This is a repost as I did not receive any replies...
Hi all,
I have a mother who complains of tingling sensations in her
legs only
when breastfeeding. Position of the baby or her body doesn't
seem to
make a difference. She says she can sit in the same position
before
and after breastfeeding and be fine. Only when actually
nursing does
she experience these sensations. This is a new occurrence for
her.
Baby is 10 weeks old. Mother did mention excessive postpartum
bleeding; almost was transfused. CBC levels a month ago were
normal.
Any ideas? I'm stumped!
Becky Flora, BSed, IBCLC
Kingsport, Tennessee
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Date: Tue, 21 Mar 2000 11:31:37 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: Marketing
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I just received an advertisement from a baby store in our area to let us know
that they are now carrying alternative feeding devices such as the SNS,
fingerfeeders, etc. I am growing increasingly concerned regarding marketing
practices from the pump companies, especially Medela. These items do not
belong in the baby stores where parents see these things and "believe" they
need these things to breastfeed. Most moms do not need pumps, but it seems
every mom has to have one these days. More and more we seem to be getting
away from the baby and mom. I see the pump companies becoming like the
formula and drug companies with their selling tactics, freebies, "free" CEU
offerings. While they may be promoting breastfeeding, it seems to me they are
promoting themselves and their products, not really breastfeeding. Am I alone
in thinking this way?
Lisa Enger RN IBCLC
Boston, MA
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Date: Tue, 21 Mar 2000 10:01:34 -0400
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Diane Wiessinger <[log in to unmask]>
Subject: test weights
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I do a lot of test weights as Jan Barger described: to confirm what the
mother and I already suspect and help us figure out just where we are.
Mothers seem almost relieved to see that, by golly, their baby *isn't*
feeding well, just as they thought. And I'm usually relieved too, because
they generally do better than I thought they did. For an occasional baby
who has come back and come back and come back, the ever increasing "inputs"
have become part of a triumphal process the mom and I go through as we work
through the problems.
But I've done the reverse too. I wrote 2 months ago about a type 1 diabetic
mother whose milk supply just wasn't quite adequate for her little 5 pound
10 oz (2.5 k) baby. Right or wrong, we pinned it on her excessive blood
loss at delivery and have hoped for a gradual rebound. Keeping her baby
exclusively breastmilk fed has been very important to her, and getting her
milk supply up to his needs will say clearly to her something she really
wants to feel - that her body can do something normal and well. So we've
had our fingers crossed, we've watched his weight carefully, and she delayed
supplements as long as she could.
He limped along, paralleling his "birthweight curve" but from a point about
8 oz below it, never regaining the ground he lost initially, and his weight
gain finally wheezed to a halt at about a month. She began supplementing
with 6 oz per day of a friend's milk, and his weight began to catch up. But
the friend's supply of extra milk diminished, and she's been using only 4 oz
per day for the past week. The mom has had two previous episodes of
feeling fuller, feeling more confident, having more leaking, hearing more
gulping, and she just recently had another such episode, as if her supply is
racheting itself upward a notch at a time.
The gain this past week, on reduced supplement? Over an ounce a day, to
just shy of 9 lb. For the first time, he's actually *over* his birthweight
projection. She's delighted, but her delight was tempered by the few test
weights she's done at home with a digital scale. They've never shown a 2 oz
intake. "I think now we just start relying on the magic of the whole
thing," I told her. "The bottom line is he's gaining better than ever on
less supplement than before. Who cares exactly how he's doing it?"
For me, test weights have a very important place. But so has magic.
Diane Wiessinger, MS, IBCLC Ithaca, NY
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Date: Tue, 21 Mar 2000 10:44:01 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Kathy Dettwyler <[log in to unmask]>
Subject: bathing babies
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My first and last were bathed every day in the tub at home. Parent gets in
tub, sits with knees drawn up at a comfortable angle, baby placed on "lap",
umbilical stump fully submerged, mother's "crotchal region" (as we call it
in our family) fully submerged, baby washed with Johnson's baby soap or
Ivory or something similar. No chance of burning the baby because mother
or father is already in the water. No problems with umbilical cords
healing nicely and coming off cleanly. Middle child had a gastrostomy
tube, so he was just sponge bathed.
Most babies in the US are bathed at first in a plastic tub with a reclining
back, with most of their body wet but not submerged (therefore babies get
COLD), and water dribbled over them with the parent's hand or poured from a
cup, and gently washed with a washcloth.
Newborns in our local hospital may or may not always get that "under the
full-force water" scrubbing with a nail brush. I only saw it one time.
Have no idea if it is routine.
----------------------------------------------------------------------------
-------
Katherine A. Dettwyler, Ph.D. email:
[log in to unmask]
Anthropology Department phone: (409) 845-5256
Texas A&M University fax: (409) 845-4070
College Station, TX 77843-4352
http://www.prairienet.org/laleche/dettwyler.html
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Date: Tue, 21 Mar 2000 13:12:10 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Julia Scaletta <[log in to unmask]>
Subject: Spanish
Hi. This is my first time posting to LACTNET. I am a lactation consultant in
a small community hospital in Eden, NC. Our Mexican population is growing
rapidly and I speak very little Spanish. Does anyone know of a good book
that has phrases related to breastfeeding translated in Spanish? We have
excellent Spanish videos, but I would like to be able to communicate with
them directly. Thanks for your help.
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Date: Tue, 21 Mar 2000 19:19:33 +0100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: tingling sensations in legs only when breastfeeding; REPOST
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> This is a repost as I did not receive any replies...
>
>
> Hi all,
>
> I have a mother who complains of tingling sensations in her
> legs only
> when breastfeeding
I'd love to give you lots of answers, but really I haven't got the faintest
idea, I was just hoping someone would write and say; Oh I've seen this a lot and
it means ....
Gonneke van Veldhuizen, IBCLC
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Date: Tue, 21 Mar 2000 19:27:47 +0100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: Marketing
MIME-Version: 1.0
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> Lisa Enger wrote:
> I see the pump companies becoming like the
> formula and drug companies with their selling tactics, freebies, "free" CEU
> offerings. While they may be promoting breastfeeding, it seems to me they are
> promoting themselves and their products, not really breastfeeding. Am I alone
> in thinking this way?
You're absolutely not! I fully agree.
I think feeding assisting divices belong somewhere were they are sold by
knowledgable people, to come with instruction and follow up.
To breastfeed, one only needs a hungry baby and a pair of breasts (well, half a
pair will do, actually).
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
http://www.users.skynet.be/eurolac
[log in to unmask]
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Date: Tue, 21 Mar 2000 13:45:06 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: Pharmacy abreviations
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Chris, in your (as usual! ) helpful and interesting post on herbal potency
and dosages you wrote:
<<
I have found that most people don't realize that one should start patients
off on low dose 450 mg capsules twice a day and work up to as many as 3-4
capsules TID or QID to get the full effect (Yup, that's a lot of capsules).
Some moms don't need more than 2 TID, but many won't show improvement until
they get up to the higher dose. >>
Can you translate these abbreviations into patient-speak for the non-hcps and
DPharms among us? Thanks!
Elisheva
lay person but plugging away in NYC
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Date: Tue, 21 Mar 2000 10:58:29 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: herb dosages
Comments: To: [log in to unmask]
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Pat: In particular, I start moms on 450 mg caps of fennugreek and depending
upon their particular issue, I may add other herbs. Hops and wild yam with
chaste tree are particularly good herbs for let down problems and moms
having estrogen withdrawal nightsweats or insomnia. It all depends...If you
have a specific circumstance, I'd be happy to say how I would deal with it.
Warmly,
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Tue, 21 Mar 2000 11:05:40 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: fee schedule
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Hello all! I'm looking for anyone who is willing to generously share their
fee schedule with me. I currently charge per hour (in 15 min increments)
plus supplies and transportation. I'm thinking of switching over to set
fees. Please note that I will of course keep all correspondence in
strictest confidence. TIA!
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Tue, 21 Mar 2000 14:23:12 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: fee schedule
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In a message dated 03/21/2000 11:10:15 AM Pacific Standard Time,
[log in to unmask] writes:
<< Hello all! I'm looking for anyone who is willing to generously share their
fee schedule with me. I currently charge per hour (in 15 min increments)
plus supplies and transportation. I'm thinking of switching over to set
fees. Please note that I will of course keep all correspondence in
strictest confidence. TIA!
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
>>
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Date: Tue, 21 Mar 2000 14:40:01 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Kathy Dettwyler <[log in to unmask]>
Subject: McKenna and Gartner's letter
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Can somebody quick send me by private email the text of the letter by Drs.
McKenna and Gartner refuting the consumer products claim that bedsharing
was unsafe? Or tell me where it was published? I tried searching the
archives, but couldn't come up with it. Thanks.
----------------------------------------------------------------------------
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Katherine A. Dettwyler, Ph.D. email:
[log in to unmask]
Anthropology Department phone: (409) 845-5256
Texas A&M University fax: (409) 845-4070
College Station, TX 77843-4352
http://www.prairienet.org/laleche/dettwyler.html
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Date: Tue, 21 Mar 2000 16:19:28 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: newman <[log in to unmask]>
Subject: test weighings
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I have not really been following this thread. But in the case that Ann
describes, the real problem is not the scale but the lack of knowledge on
the part of the nurse. Until nurses and doctors learn that a baby can get
lots of milk in ten minutes on the breast *if they are drinking*, but may
get nothing while on the breast for 30 minutes *just nibbling* we will never
get anywhere. By using test weighings, though, we are playing the numbers
game too. A baby who breastfeeds with a pause at the chin on maximum
opening, just got a mouthful. When are we going to understand this?
Jack Newman, MD, FRCPC
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Date: Tue, 21 Mar 2000 13:40:55 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Katherine Catone <[log in to unmask]>
Organization: home
Subject: Re: pharmacy abbreviations
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The abbreviations are from the Latin, cuz most pharmacy language
regarding prescriptions are in Latin.
qd: every day
bid: twice a day
tid: three times a day
qid: 4 times a day
-
Katherine Catone, LLLL, IBCLC
http://www.pe.net/~skcat1/index.html
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Date: Tue, 21 Mar 2000 15:47:10 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Maurenne Griese <[log in to unmask]>
Subject: Re: tingling sensations in legs..sexual response?
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Becky,
Here's my idea... This may be a really far-out response on my part but is it
possible that she is experiencing part of the female sexual response while
breastfeeding? Has she described feeling aroused while nursing? Since some
women have described feeling sexually aroused when breastfeeding, could this
explain the tingling sensation in her legs (I'm thinking upper legs here),
especially since she feels it only when nursing? Again, I may be way off
base here, but it was a thought. I'd appreciate hearing what others have to
say about my 'theory'.
Sincerely,
Maurenne Griese, RNC, BSN, CCE, CBE
Manhattan, KS USA
[log in to unmask]
http://www.networksplus.net/griese
> This is a repost as I did not receive any replies...
>
>
> Hi all,
>
> I have a mother who complains of tingling sensations in her
> legs only
> when breastfeeding. Position of the baby or her body
doesn't
> seem to
> make a difference. She says she can sit in the same
position
> before
> and after breastfeeding and be fine. Only when actually
> nursing does
> she experience these sensations. This is a new occurrence
for
> her.
> Baby is 10 weeks old. Mother did mention excessive
postpartum
> bleeding; almost was transfused. CBC levels a month ago
were
> normal.
>
> Any ideas? I'm stumped!
>
> Becky Flora, BSed, IBCLC
> Kingsport, Tennessee
>
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Date: Tue, 21 Mar 2000 16:59:34 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Kris Everette <[log in to unmask]>
Subject: Chemotherapy during pregnancy
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How long do chemo drugs given during pregnancy stay in the mom's system? An
oncologist has asked in regards to a patient who had a mastectomy during
pregnancy and received Adriamycin and Cytoxan. She finished the chemo at
about 29 weeks gestation and is now 34 weeks. I can't seem to find this
scenario anywhere he said he could't either.
Thanks
Kris Wiedman RN IBCLC
in East Tennessee
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Date: Tue, 21 Mar 2000 14:37:36 -0800
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: 10 minute nursing
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I believe it was Dr. Jack Newman who said that if the baby was sufficiently
draining the milk sinuses (including with breast compression) that there
shouldn't be any reason why a single nursing session should take more than
10 minutes from a nutritional perspective. If baby was truly needing
extended nursing sessions all the time to meet the nutritional component,
then the mom should probably be taught breast compression. I'm paraphrasing
based on a LN post from oh maybe 3 years ago, but you get the point.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Tue, 21 Mar 2000 14:41:37 -0800
Reply-To: Lactation Information and Discussion
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: vaso-spasm
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Becky: I'll take a stab at this since no one else did...My impression is
that this mom may be experiencing a vaso-spasm, perhaps similar to what some
people experience in the vaso-vagal response. Does she have any symptoms
of Raynaud's syndrome? Did she have any symptoms during pregnancy. If she
were my patient, I'd probably want a full physical work up (that's why I
hadn't commented earlier). Has she seen a chiropractor? Depending on the
answers to the above, one possible treatment would be to use niacin as a
vaso-dialator.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Tue, 21 Mar 2000 14:46:07 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: abbreviations
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Sorry about the abbreviations...BID=Two times per day, TID= three times per
day, QID= four times per day, caps = capsules
Sometimes I just need to be reminded, so don't be afraid to ask. My dh just
rolls his eyes when I do this and it gets the point across. We don't have
that advantage (is there a symbol for that?)
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Tue, 21 Mar 2000 18:11:14 -0500
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From: Robert Cordes DO <[log in to unmask]>
Subject: cefuroxime
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I'm trying to rapidly catch up on Lactnet.
In case this wasnt answered, it's asecond generation cephalosporin, OK for
babies, OK for breastfeeding moms.
Rob
Rob Cordes, DO, FAAP, FACOP
general pediatrician
Wilkes Barre PA
mailto:[log in to unmask]
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Date: Tue, 21 Mar 2000 18:17:23 -0500
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From: Robert Cordes DO <[log in to unmask]>
Subject: rocking the baby
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I'm getting a lot of lactation problems beyond the norm the past few days.
The most recent is a well 4 month old who will latch then about the time let
down occurs will fuss and come of the breast. Mom needs to calm her then
relatch and keep rocking her during the feed.
Baby does the same with bottle feeds so I'm thinking the let down is a
temporal event not a causal one.
When asked about reflux mom says it isn't as bad as in the past. Makes me
wonder if she (baby) refluxes 3/4 of the way while feeding.
We discussed options for empiric treatment of reflux and mom decided to keep
rocking while feeding.
One of the recent problematic moms was apologetic but I reassured her it was
good practice for me, "With newer vaccines soon my practice will be
lactation and ADHD."
Any other ideas why the baby wants to be rocked while feeding?
Rob
Rob Cordes, DO, FAAP, FACOP
general pediatrician
Wilkes Barre PA
mailto:[log in to unmask]
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Date: Wed, 22 Mar 2000 12:09:54 +1200
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From: mark and donna <[log in to unmask]>
Subject: Unsubscribe
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Date: Tue, 21 Mar 2000 19:35:39 -0500
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From: Patrica Young <[log in to unmask]>
Subject: baths/blood/HIV
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After my comment on baths & HIV I've gotten some messages re: good reason
to leave baby with mom. Now guys, I KNOW that! It's just all the
hospitals and HCPs who don't know that :-) Actually I've said it before
and I'll say it again. Birth in the US in most places is as bad or worse
than the 1950s-1960s. Mother/baby separation for all sorts of reasons
continue to be the norm. sincerely, Pat in SNJ
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Date: Tue, 21 Mar 2000 20:33:14 EST
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From: Gloria Buoncristiano-Thai <[log in to unmask]>
Subject: My 5 minutes of fame---maybe 3
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Aloha,
Well I did it. It was a great experience. Next time I'll bring notes, just
in case.
The person who was setting up the interview, pulled out points from my
article on breastfeeding and baby friendly hospitals. I received a copy and
the interviewer was to receive a copy from which she would draw her
questions. No problem. Yeah right.
When I arrived, the interviewer asked me what we were going to be talking
about! You mean you don't know, I said.
She pretty much fumbled with questions. It went okay, but if she had been
prepared, it would have been a lot better.
Live and learn.
Aloha,
Gloria Thai
Honolulu, O'ahu, Hawai'i
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Date: Tue, 21 Mar 2000 20:40:46 -0500
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From: "Paula M. R. Hart" <[log in to unmask]>
Subject: Re: Sibling class teaching bottlefeeding
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I had the same problem last March when I took my girls for sibling classes
at Bon Secours St. Francis Xavier in Charleston, SC. I wrote a letter to
the hospital and got an apology letter, but I sincerely doubt that it has
made a difference.
Paula Hart
[log in to unmask]
At 08:32 PM 3/18/2000 EST, you wrote:
> In the March 17th Greenville news, Lifestyle Section, there was an
>article picked up from Scipps-Howard, written by Stasia Scarborough regarding
>a sibling preparation class at Mercy Medical Center, near Anderson and
>Redding California.
>The siblings are taught how to help with things like diaper changes and
>"feeding". There is a large picture of a 5 year old feeding her "baby" with
>a bottle. Apparently, all of the siblings are taught bottlefeeding. Anyone
>on the list from Mercy Medical Center who could have some influence on the
>"normal" way to feed a baby? I am writing a letter to the editor of our
>paper.
>
>Alice Ernest IBCLC
>Simpsonville, SC
>
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Date: Tue, 21 Mar 2000 18:11:32 PST
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From: laurie wheeler <[log in to unmask]>
Subject: tub baths
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To the lactnut who asked about tub baths, you might contact Evergreen Hosp
in Kirkland Washington USA, the first baby friendly USA hospital. They do
tub baths in a sink/tub in mom's room I believe. This is not exactly your
situation, but they may be able to help you. Molly Pessl has done an
absolutely wonderful job with their BF and parenting programs and if you
ever get a chance to hear her speak about this, it is a wonderful
opportunity. However, it can make you a bit depressed to see how far they
have gone and how far behind them you really are.
Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA
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Date: Tue, 21 Mar 2000 18:18:33 PST
Reply-To: Lactation Information and Discussion
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From: laurie wheeler <[log in to unmask]>
Subject: I second Jan on test weights
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Jan,
I hate to admit it but I am fooled by the long slow sucks too. In the
general hospital postpartum population, I point out the open pause close
sucks (or as I sometimes say the "long, strong sucks), the swallowing sounds
etc. If I have a consultation, however, this means there is a problem and
very often I do the pre and post weights. Not infrequently I get much less
or even much more of a milk transfer than I had judged. If the BF just needs
a little fine tuning, the output is pretty good, the milk is there, then I
usually don't do the weights. But if the baby is losing weight, the breasts
are not full, there is surgical history or other red flags, I will do the
wts. I feel they are very valuable in this context.
<<But I do want to point out that I've been fooled more than
once by "hearing swallows" and SEEING long, drawing, nutritive suckling, ...
and to check the weight and find out he took a whole lot less than I thought
he did.>>
with are happy to do it, and don't view it as a "test" they have to pass.>>
Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA
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Date: Tue, 21 Mar 2000 18:22:56 PST
Reply-To: Lactation Information and Discussion
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From: laurie wheeler <[log in to unmask]>
Subject: I second Winnie on test wts
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Not to be redundant, but I feel I should contribute by saying I totally
agree with Winnie, as below. This is what the 4 of us ibclcs in my office
do.
<<I always tell a mom beforehand that the weights do not give us a full
picture of what is happening over all the feedings in a day. It is more of
a "snapshot" of that individual feed. [snip] In a situation where baby
definitely needs to be fed and mom is working on her supply but is not
obtaining as much as baby needs, test weights can give a "ballpark" idea of
how much additional milk baby may need>>
Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA
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Date: Tue, 21 Mar 2000 19:21:36 -0500
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From: "Catherine Watson Genna, IBCLC" <[log in to unmask]>
Subject: Re: Lipase & Lactase
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I think you are confusing lipase and lactase.
Lactase breaks down lactose into glucose and galactose. Lipase is a fat
digesting enzyme. Just want to get the story straight for the students
among us. ;-}
--
Catherine Watson Genna, IBCLC New York City mailto:[log in to unmask]
Patrica Young wrote:
>
> No, it is not glucose and galactose. Lipase breaks Lactose down into
> galactose and glucose. Galactose and glucose are not breastmilk components
> per se. Lactose has to be processed by the lipase for them to to show
> up. Check any BF text. Sincerely, Pat in SNJ
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Date: Tue, 21 Mar 2000 21:15:23 -0600
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From: Kathy Dettwyler <[log in to unmask]>
Subject: chemotherapy during pregnancy
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>Kris Everette <[log in to unmask]>
>Subject: Chemotherapy during pregnancy
>
>How long do chemo drugs given during pregnancy stay in the mom's system? An
>oncologist has asked in regards to a patient who had a mastectomy during
>pregnancy and received Adriamycin and Cytoxan. She finished the chemo at
>about 29 weeks gestation and is now 34 weeks. I can't seem to find this
>scenario anywhere he said he could't either.
Well, I wasn't pregnant when I had chemo (thank goodness) but I do know (as
the oncologist certainly ought to know) that the chemo drugs work
immediately and are processed out within minutes/hours.
Adriamycin -- affectionately known as "The Red Devil" for its red color, is
administered by "push" through an IV, followed by the Cytoxan, which is
dripped in. By the end of the 1.5-2.0 hours of chemo, you get up and go
pee, and your pee is bright orange from the Adriamycin. Next time you pee,
it is back to its clear yellow color. The adriamycin "does its stuff" and
gets processed out by the kidneys within two hours.
I'm just a patient, not a medical professional, but it is my understanding
that all the drugs clear within just a few hours.
One would think that chemotherapy would be devastating during a pregnancy,
as the mechanism by which it works is to kill rapidly dividing cells (which
is why one loses one's hair and sometimes one's nails, and the lining of the
GI tract from stem to stern). However, I know from the breast cancer email
list I was on that a number of women have chemotherapy during pregnancy and
go on to deliver apparently normal, healthy babies. I have heard of other
people who stopped nursing to start chemotherapy, however (rather than pump
and dump for a particular length of time).
Why does the doctor particularly want to know? Since you posted this to
Lactnet . . . surely the doctor doesn't think that the drugs will get into
her milk so many weeks afterwards?????
Kathy Dettwyler, *all done* with being sliced, poisoned, and fried, and
growing hair again! :)
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Date: Tue, 21 Mar 2000 21:15:26 -0600
Reply-To: Lactation Information and Discussion
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From: Kathy Dettwyler <[log in to unmask]>
Subject: Duration of nursing session
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Chris writes:
>if the baby was sufficiently
>draining the milk sinuses (including with breast compression) that there
>shouldn't be any reason why a single nursing session should take more than
>10 minutes from a nutritional perspective.
It depends on the baby -- its neurological functioning, how hungry it is,
the efficiency of its sucking, its strength, if it is healthy or sick, etc.
etc. etc.
Not to mention the more important point that breastfeeding is much more than
nutrition, and that some children are leisurely nursers, while others are
barracudas, and others change from day to day or nursing to nursing.
I have one (sitting on the stairs reading a book as I type) who liked to
spend 1-2 hours nursing every morning to *ease into the day*. He would
drift in and out of sleep, gradually waking up, but always latched on,
always sucking, getting milk and love. He is still not a morning person.
My eldest, by contrast, would be quick and efficient in the morning as she
was an early riser and wanted to be up, fed, and about her business -- but
later in the day she would nurse for longer stretches.
Kathy Dettwyler
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Date: Tue, 21 Mar 2000 19:37:02 -0800
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: Re: herbs
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Cheryl: I've presented "Herbs and their potential Uses and Dangers While
Breastfeeding" at conferences and have an outline I could share with you.
Otherwise, the best single source for non-herbalists would probably be THE
COMPLETE MEDICINAL HERBAL by Penelope Ody published by Dorling Kindersley
books.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Tue, 21 Mar 2000 23:57:17 EST
Reply-To: Lactation Information and Discussion
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From: Carol Brussel <[log in to unmask]>
Subject: getting milk - newman's law
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<< A baby who breastfeeds with a pause at the chin on maximum
opening, just got a mouthful. When are we going to understand this? >>
oh, come on jack, just repeat after me "you don't have any milk until your
milk 'comes in,' you don't want to starve your baby, do you?" "your baby is
latched on just fine, your nipples don't look too bad, don't be a wimp, now,
surely it can't hurt that much" "well, lots of mothers can't make enough
milk, now here are some samples of formula for you to have for free," oh, i
can't even type any more of them, they make me sick.
of course there's one said in private, too, "he has a lot of experience so
that's why he can tell by looking, but that's not reliable and its dangerous
to not do a test weigh."
here's your new motto: it ain't milk until its measured. look how convenient
it is to look at the markings on the side of the bottle. metric AND american.
carol brussel IBCLC
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