Going to try to reply to everyone all at once RE: Empty breasts I've been following the discussion on *empty the breast*. First, although I've heard the modified sweat glands idea about the breast (In microscopic structure they resemble sweat glands) and the apocrine theories this is not something I would share with moms in a class. Too many of the mothers already have problems identifying milk apart from other bodily secreations and excreations. (I also try not to use *secrete and excrete* terms in classes.) My understanding is that the terminology *empty the breast* comes to us via the dairy industry. An udder empties and then refills after about 4 hours depending on the animal. This is one of the reasons we used to tell moms to only nurse every 4 hours because the breast was empty. ******** Estrogen often used for uterine infections Judy K wrote about a woman with a uterine infection post partum and baby's subsequent slower weight gain. It brought to mind a practice of some OB's in my area. Women with postpartum uterine infections are often given high dose estrogen to prevent uterine scarring. I am not sure of the phisology re the scarring but I do know that the estrogen causes a temporary drop in milk supply. It has been my experience that within a few days after the last dose the supply becomes ample again. ********** RE: Food refusal Our clinic dieticians (sp?) often get referrals for children who will not eat. One of the most unusual was a toddler who refused all solid food. The diagnosis was anorexia nervosa (right :-( ) There were no physical problems but months went on with no change in behavior. Finally, someone thought to ask the mother if she knew of a reason why the behavior started. She said "I tried to tell them months ago, this all started when she choked on a piece of hot dog. She hasn't taken a bite since." (Strange how mom never mentioned it again) Anyway, this child was sent for some type of behavior modification to reduce the fear the child had of choking. Within a few weeks she was eating like a horse! Another stopped eating after being orally (sexually) molested. Imagine the trauma to the child if this mom does wean and force feed the baby. What if the poor child can't eat? Allow the babe to starve, put in a tube? Why don't these doctors think before they speak? Does the doc think the child is *willful or being stubborn*? Like these kids plan this out or something: really! :~( = symbol for a punch in the nose. Someone should wake him and his kind up! Any wonder why eating disorders are so prevelent? I agree with Jan . <Guess the moral of the story is we shouldn't make food an issue, because as we know, we can't control children through food - though they can control us. (Look at the number of anorexics....)< ************ RE: Migranes Being a migrane suffer myself, I know that my worst migranes follow my cycle especially in the pms period. :-( . I had migranes while nursing and the popular treatment was an ergot preparation. (Some docs still use these and it reduces supply.) Some migrane suffers like myself experience attacks that last for several days. Self education is a key in treatment. The mother should be questioned regarding aura-- does she know before they hit? If not she should watch for an aura. The aura can be subtle, a flash of light in the eye, a funny twitch in the face, color distortion, or just a strange feeling. Do they seem to start if there's a sudden change in barrometric pressure (I discovered this connection by accident)? Do certain foods set it off? Mine used to get so bad that I had to be hospitalized for rehydration. If I can get on top of mine in the aura stage they won't go on for days. I take Fiorinal (no codiene) generic is: butalbital CPD tabs. I've been lucky and haven't had to resort to shots of Toradol (ketorolac tromethamine) for over 2 years-- knock on wood. My daughter was diagnosed at age 7 my son at age 9 They take naprosyn when they become aware of the aura. I worried about passing on my hip to my kids, instead I gave them migranes (Wait a minute-- they give me migranes some days) ************** RE: Janet's ? Premie Janet, A baby born 3 weeks before the due date is not a premie. Normal gestation range is 37 to 42 weeks. A 37 weeker should have a developed suck reflex. Even at 36 wks there should be a suck reflex. Give us some info on the birth, I think that we might be able to find some other cause for the poor suck. ******* Medline search info, me too please Will someone please email me privately too re: HOW to do a medline search for breastfeeding or other medical literature. TIA (Davisrnclc@ AOL.com) ************** Which one of US do you want? Seeing how a lot of us have the same first names, maybe we should add the last name or at the least the initial. There appeared to be a post addressed to Marie about milk loss from nipple shields. I don't remember addressing this issue. Did you mean me? Marie Davis or Marie Biancuzzo? I see Marie Biancuzzo answered the post however I'd like to avoid confusion for others as well, ************** No mystery to 3 mo milk disappearence. Several things are happing that lead to the false belief that the milk is gone at 3 mo. Prolactin levels have returned to normal. Mom's body just figured out there aren't twins to be fed so she stops overproducing. Thus, her breasts are more efficient at making milk. She doesn't have to be engorged or overfull all the time. Leaking also stops at about this stage. Most women find that at 3 mo pp they can return to their origional bra cup size. Those of us who nursed children well into toddlerhood can attest that the breast begins to soften and feel more normal around 3 months. With the prolactin near baseline, milk supply becomes dependent on suckling, milk removal and oxytocin release. (See Lawrence for more info) 3 mo growth spurt happens. Lastly the baby's oral structure has changed, so the baby who had a suckling problem in the begining either gets better, because he can produce more suction; or worse because he can't get the same compression. I find that if mother's are warned of these events in advance they continue to nurse and don't express fears about lost milk. ******************** RE: CPS (Child Protective Services) and cocaine pos mom Robin H, Many counties in Calif. now have a policy of removing the baby if the mom tests positive for illegal substances. It is considered by many to be prenatal child abuse. There are statistics on abrupted placenta and pre-term labor with crack cocaine use. I am glad the social worker is concerned regarding the BF. Couldn't they test the milk for cocaine and it metabolites too? If she's been saving it, couldn't the court send someone out to take random samples (provided they are dated and timed) Perhaps they could make a decision to return the baby earlier if mom truely is clean. Unfortunately, it has been my experience that if mom was using in pregnancy and shortly before labor she doesn't stop just because she's nursing. ********* Table Sugar and botulisim Arly Helm asked if they were sure about the source in the cases I mentioned previously. The neonatologist sent someone out from public health in all three cases. Two of the sources were indeed table sugar. Think about the typical family sugar bowl for a moment. The sugar inside gets damp from spoons etc and then sits around. Who knows how long the bowel itself goes between washings. My own pour type dispenser even gets damp inside if its held above a steaming cup of tea. On the corn syrup the health department found it in the cabinet. I had been open for months and mold was clearly visable in the bottle. If I remember correctly, botulism is loading dose dependent. It takes a fairly small amount of spores to infect an infant compaired to the adult. That's why some are now recommending no honey for children under 5 yrs, here in my area. We routinely caution parents about table sugar and corn syrup as well. We had another case that baffled the health department last year. A toddler came down with botulism and it took a Sherlock Holms to put the clues together. The family recently had an in ground pool constructed. Needless to say they weren't housekeeping fanatics. The dust in the house and the carpets contained botulism spores. How's that for kids putting everything in their mouthes? The results of the toxin are treatable if caught quickly. The babies required respiritory support and several weeks (months) in the hospital. Horrid thing to watch. By the way the neonatologist insisted that these kids have breastmilk (via tube because the swallow reflex disappeared for a time) ****** Marie Davis