And I had a chipped tooth from the tube! I was actually called by the
doctor to check on my tooth!
Jacie in Albuquerque
=========================================================================
Date: Fri, 1 Jan 1999 18:08:50 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: PrMechell Roberts Turner <[log in to unmask]>
Subject: rape, psychobabble
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Jay,
Eloquently said.
Mechell Turner, who is Still at times emotionally physically defensive years
later.
-----Original Message-----
From: Automatic digest processor <[log in to unmask]>
To: Recipients of LACTNET digests <[log in to unmask]>
Date: Friday, January 01, 1999 1:16 PM
Subject: LACTNET Digest - 1 Jan 1999 - Special issue
=========================================================================
Date: Fri, 1 Jan 1999 18:18:20 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Chris Mulford RN IBCLC <[log in to unmask]>
Subject: containers for expressed milk
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What's wrong with glass canning jars? They are strong---made for boiling and
freezing and meant to be re-used many times. They are quite cheap, and in the
US they can be bought at your local supermarket (especially in late summer, of
course). They come in many sizes down to about 4 ounces, or maybe it's 6.
When I was a hospital nurse we were told---by administration? by the formula
reps?---that the water and formula bottles provided by the companies were
meant to be used once and thrown away, not re-used, and thus were of a weaker
type of glass that would chip more easily. I don't know whether this was
true. The formula reps certainly had no incentive to make milk expression and
storage any easier for us or our moms.
When I worked night shift in the nursery I sometimes finished my 8-hour shift
with a whole bucket of empties to bring back for the hometown glass recycling
program. Just another bit of info about the sorry state of infant feeding at
my former workplace. Single-serving packaging is surely the most wasteful way
to formula-feed!
That last paragraph is a tiny rant to start 1999 off right.
Peace and justice to all of us for 1999.
Chris
=========================================================================
Date: Fri, 1 Jan 1999 18:29:46 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Cindy Curtis <[log in to unmask]>
Organization: Benefits of Breastfeeding
Subject: Re: Suctioning again
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Jay said : "she used a long, clear, thin
tube and I believe (tho I could be wrong, I was a bit distracted at the
time
:) ) that she did the suctioning by sucking ever so gently on the tube,
herself."
This is called a DeLee Trap and it is no longer recommended to be used
due to the practitioner using it could potentially infect them self with
what they are suctioning out.
Cindy
--
Cindy Curtis,RN,IBCLC
Virginia,USA
mailto:[log in to unmask]
Benefits of Breastfeeding Page http://www.erols.com/cindyrn
=========================================================================
Date: Fri, 1 Jan 1999 18:30:19 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
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From: PrMechell Roberts Turner <[log in to unmask]>
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for the patient with thrush. I would start her on some homwopathic remedies
quickly. can still use these with the diflucan etc. anbd a couple of
herbals.
herbal calendula- wiht a litlle black walnut on the nipple. for the pain and
intense iting in the breasts. phytolacca and then belladonna rotating each
remedy. try 30 c if bad may need a 200C start with number of pellets on
bottle for every 2-3 hours and cut back as symptoms decrease. Castor equi
is great for the sore cracked nipples will help with the violent itching in
the breast.
mechell turner, m.ed IBCLC. CCe
-----Original Message-----
From: Automatic digest processor <[log in to unmask]>
To: Recipients of LACTNET digests <[log in to unmask]>
Date: Friday, January 01, 1999 1:16 PM
Subject: LACTNET Digest - 1 Jan 1999 - Special issue
=========================================================================
Date: Fri, 1 Jan 1999 18:11:38 -0600
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Jill Lund <[log in to unmask]>
Subject: Vitamin D
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Recent BMJ topics: At least the last article did mention sunshine!! and
that Vit. D production begins in our bodies when sunlight hits our skin.
Admittedly, supplements can be useful, but sunshine is nature's way (and
is more effective). There may be other processes that we get from sunshine
that are not yet well known. Babies were not meant to be inside all the
time. There is a happy medium between no outside exposure and too much.
Certain ethnic groups do have more melanin in their skin which is the
pigment that gives our skin color. It does then take a little longer for
the sunshine to activate the process of Vit. D formation when the climate
is less sunny than their genes were prepared for.
Yes, there are persons who cover up for religious reasons when out in
public. Exposure of just hands and face can produce enough Vitamin D. The
problem comes when no one tells these parents the importance of sunshine
for Vit. D formation. Once they know, sunshine is more acceptable to some
than taking a pill. If, after being given information on the importance of
sunshine, a client makes a choice to not be in sunshine, then
supplementation may be needed (mother's dietary intake of Vit. D fortified
foods can also be checked).
Parents need information on Vit. D, just like they do on formula.
Breastfeeding mothers can learn to take their baby outside more often
(leave off the sunblock and don't over expose), and if not possible because
too cold or hot for their belief system, to then get themselves out in the
sunlight a bit more so that their milk will have a higher Vit. D
concentration (can also increase Vit. D sources in diet, but sunshine is
best -- admittedly not much sunshine around this time of year, but the body
stores it.) If smokers can take breaks to light up, even
working-outside-the-home breastfeeding moms can take breaks to get a little
sunshine -- Actually they'd be nursing or pumping at break so I guess we
would see moms out at picnic tables breastfeeding or hand expressing or
pumping their milk! :-)
We had a 1 year old breastfed baby that we thought had rickets, and
asked the doctor if Vit. D supplements were necessary == this lead us to
read up a little and now we do a class that our WIC moms and staff quite
enjoy on "the Sunshine Vitamin - Vitamin D"
Jill Lund, RD, MS St. Louis, Missouri, USA
----------
From: Marie Davis, Rn, Clc <[log in to unmask]>
To:
Subject: latest bmj topics
Date: Friday, January 01, 1999 12:54 PM
Happy New Year to all my Lactnet buddies!!
Marie Davis, Rn, IBCLC
=============
Breast feeding is best learnt by example
http://www.bmj.com/cgi/content/full/318/7175/0/e
Asian children in the UK may need vitamin D
http://www.bmj.com/cgi/content/full/318/7175/0/f
Vitamin D concentrations in Asian children aged 2 years living in England:
population survey
Margaret Lawson and Margaret Thomas
BMJ 1999;318 28
http://www.bmj.com/cgi/content/full/318/7175/28
Qualitative study of decisions about infant feeding among women in east end
of London
Pat Hoddinott and Roisin Pill
BMJ 1999;318 30-34
http://www.bmj.com/cgi/content/abstract/318/7175/30
Lesson of the week: Florid rickets associated with prolonged breast feeding
without vitamin D supplementation
M Z Mughal, H Salama, T Greenaway, I Laing, and E B Mawer
BMJ 1999;318 39-40
http://www.bmj.com/cgi/content/full/318/7175/39
----------
=========================================================================
Date: Fri, 1 Jan 1999 17:26:42 -0700
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: The Jones Family <[log in to unmask]>
Subject: Knowing normal breastfeeding and one-week lactation courses
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I was thinking about Vicki's comments on knowing normal breastfeeding as
a means of spotting what is abnormal. This is definitely very
important.
Since I was in nursing school the year Rob was born, I didn't learn at
that time many of the things which are now considered part of routine
nursing assessment. When I was in school, my only need for a
stethoscope was for taking blood pressures. I was evidently out of
nursing when listening to lung sounds became part of the nursing
assessment. No one ever taught me. I just listened to lung sounds
until I began to be able to distinguish something that sounded different
from what I usually heard. I've learned lots of things this way as I am
sure most of you have.
As I think back on my one-week lactation educator's course, I remember
learning a LOT of things. However, what I don't remember learning were
some really basic things. I don't remember learning about hunger and
satiety cues. I learned those from a lecture Vicki gave at a childbirth
educator's course. I remember learning the importance of nutritive vs.
non-nutritive sucking from discussions between consultants at local
affiliate meetings. What helped me really learn subtle differences
between effective nutritive sucking and a less than perfect latch
accompanied by NNS (non-nutritive sucking) was the video Helping a
Mother Breastfeed. Most, if not all of these things are things I
learned AFTER becoming an IBCLC.
My point is that I think latch and positioning need to form a MAJOR core
in the curriculum of any lactation course. NEVER ASSUME basic
breastfeeding knowledge. There are lots of less important things that
can be given as handouts or can come later from books or conferences.
As we all know, latch and positioning are probably at least 80% of what
we do.
The one thing that I relied most on to tell if baby was correctly
positioned and actively sucking until I learned some of things I know
now was the pulling sensation I could feel when my hand was on the
mother's breast. I still find it very useful, but can't recall seeing
it in any literature. I think it is important to teach several methods
of evaluation as each of us uses some senses more effectively than
others. I seldom hear swallowing--probably because my hearing isn't as
good as it use to be. But I can use sight and touch to evaluate
effectiveness of breastfeeding.
Just something to think about for those of you who give courses.
Bonnie Jones, RN, ICCE, IBCLC
from the sunny S.W. USA
=========================================================================
Date: Fri, 1 Jan 1999 17:26:03 -0700
Reply-To: Lactation Information and Discussion <[log in to unmask]>
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From: The Jones Family <[log in to unmask]>
Subject: Suctioning
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I agree with Gail that brief, gentle suctioning usually does not cause
obvious breastfeeding problems. However, nurses often suction babies
who are spitting up mucus and/or colostrum, but not choking, or who
begin to choke but manage to handle the secretions themselves. Babies
are often suctioned with bulbs because their noses are stuffy and the
parent or staff member often doesn't realize that the stuffy sound is
due to the nasal mucosa already being swollen from previous suctioning
and that suctioning will make matter worse, not better.
I worked with one baby who had such severe swelling of the nasal mucosa
as a result of suctioning (don't remember the details as to type of
suctioning or reason for it) that she could only nurse with
humidification and upright positioning for 3 days. We used the
humidification (via flexible tubing hooked up by respiratory therapist)
all the time as she had symptoms of respiratory distress without it.
When she breastfed, we ran the tubing up through mom's gown to keep it
as near as possible to baby's nose. Mom used a humidifier at home, and
she is the one who later reported that it had taken 3 days before she
could nurse without it.
One other comment on bulb syringes. One of our nursery nurses who also
does home care says bulb syringes used in the hospital should not be
sent home because they all grow bacteria within 2 days. I can't
remember the name of the bacteria she mentioned--it's the one that is
common on babies on ventilators. I think she said she heard this at a
conference. Has anyone heard of this?
Bonnie Jones, RN, ICCE, IBCLC
from the sunny S.W. USA
=========================================================================
Date: Fri, 1 Jan 1999 20:48:59 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Mary Renard <[log in to unmask]>
Subject: cord cutting
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Cathy, I remember hearing the stuff about cutting the cord to avoid baby
getting jaundiced from too many red blood cells. Specifically the practice
that was frowned upon was "cord stripping," where a no longer pulsating
cord was "milked" toward the baby's body to squoosh a little more blood
into the baby. I don't know if this practice ever caught on anywhere but
it was being talked about, at least, when my first son was born almost 20
years ago. I think there was a non-scientific leap from this "cord
stripping" practice, where I can see there would be concerns, to the
practice of allowing the cord to stop pulsating, in which case presumably
the baby gets just the right amount of blood because it's his/her heart
doing the pumping, and his/her blood being pumped. But of course, there
was the grave concern about how long one has to wait around while the cord
continues to pulse, I mean really, that can't be good for anyone....
<tongue firmly planted in cheek here>
Mary Renard RN BSN IBCLC
current Lactnet lurker
former IBLCE staff member
pre-med student looking forward to MCATs in April
=========================================================================
Date: Fri, 1 Jan 1999 19:05:18 -0700
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: The Jones Family <[log in to unmask]>
Subject: Pumping for engorgement
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Someone suggested pumping on low pressure and fast cycle speed. Why
fast cycle speed? How fast? I have noticed that moms have more pain
when their babies are sucking fast and not getting milk than when they
are doing nutritive sucking. I wouldn't think you would want a mom who
is engorged to pump on a speed faster than 60 cycles per minute.
Bonnie Jones, RN, ICCE, IBCLC
from the sunny S.W. USA
=========================================================================
Date: Fri, 1 Jan 1999 18:21:05 -0800
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Melinda Hoskins, MS, RN" <[log in to unmask]>
Subject: Cord blood, etc (long)
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Happy New Year everyone!
Yes, Kathy D, the cord blood is the baby's not the mother'. (Watch out,
I just found my lecturer's platform)
What is the concern about how much cord blood the infant gets?
Primarily one that there may be too much. Can that really be? Yes,
because the closed system of baby, cord and placenta together hold more
blood than baby needs in his/her system when the cord and placenta are
removed. If extra blood is drawn away from baby and the cord cut the
baby will be anemic, not a good thing. But if extra blood is drained
into baby, ie, baby held below the level of the uterus, or cord "milked"
to give baby "a little extra" other problems can develop.
How could extra blood be a problem? Well when the hematocrit ( measure
of the red blood cells (RBC"S) as a % of blood volume) becomes greater
than 60% the chance of tiny blood clots forming in body organs
increases. Also the heavy load of immature RBC's increases the
bilirubin load which must be processed by the liver. Prior to delivery
the infant has many RBC's with what is called fetal hemoglobin designed
to attract oxygen from the mother's circulation across the membrane
which separates baby's blood from mother's. After deliver, when the
infant is receiving oxygen via the lung, fetal hemoglobin is not needed,
so is broken down by the liver, saving the iron content of these cells
for later needs and removing other products from the blood, via the gut
as bile and via the kidneys as urobilinogen.
As an example, daughter #2 was delivered using a "birthing chair" back
in 82. As she delivered very rapidly, coming out "sunny side up", head,
shoulders and rump (much to the surprise of the MD who had just told me
to "give one more big push and we'ld get this posterior baby to turn"),
there was not time for him to suction (considered absolutely necessary
in those days) her nose and mouth before delivery of the shoulders. So
he held her in his lap, about 18 inches below the level of the uterus,
suctioned her and then cut the cord, and handed her to my husband.
Three days later, after probably two dozen very soaked diapers,
transitional stools nearly every hour, weight still at birth weight, so
no question of dehydration, she had a bilirubin of 18 and a hematocrit
of 58%. We did the 48 hours of phototherapy and they checked her bili
every four hours. I was told by the ped to think of the blood draws as
mini phlebotomies to decrease her hematocrit, which was probably causing
the problem! We nursed every 1.5 hours and kept her under the lights the
rest of the time. She never did lose much weight, as a matter of fact
doubled birth weight by 3 months and tripled it by six.
In trying to answer why she had this bili problem, hubby and I both did
a lot of reading regarding cord blood, etc. Seems as though the events
surrounding delivery best explained the elevated hematocrit and the
bilirubin.
Seems a lot of other folks were concerned about delivery practices too
at that time, but I haven't read much lately, not having ready access to
OB literature where we are now.
Melinda Hoskins, MS, RN
Northern Nevada, USA
=========================================================================
Date: Fri, 1 Jan 1999 21:37:59 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Cynthia Turner-Maffei <[log in to unmask]>
Subject: Hot v. Cold (not hors d'oeuvres)
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I appreciated Mary Broadfoot's comment "I hear what is being said about
evidence based practice - I do however wonder whether it is always
appropriate to apply evidence about other body parts to the breast..."
Nikki Lee also asks some interesting questions: "Does it matter that the
breast, unlike an ankle, has an outlet to the outside for drainage? So
while we need to do things to promote flow internally to an ankle or
muscle, we need to do things to promote internal and external flow in a
breast?"
Thinking of the breast as a secretory organ experiencing greatly increased
vascular and lymphatic input while going into full swing of milk production
is quite different than thinking of injured muscle and tendon. What
comparative treatments do we have for other external secretory organs -
tear ducts? sweat glands?
Another question arises from reading this wonderful group think on
engorgement: why is pumping mentioned so often as an engorgement
treatment? It sounds as if pumping may have become the second line of
treatment after application of hot/cold for many practitioners. Why is
this--where is the baby in the midst of all this treatment?
Cindy Turner-Maffei, Massachusetts, USA
=========================================================================
Date: Fri, 1 Jan 1999 19:44:43 -0700
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: The Jones Family <[log in to unmask]>
Subject: generic names
Comments: To: Morrison Pamela <[log in to unmask]>
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Pam,
Interestingly enough, the only name I recognized was a brand
name--Panadol. The generic name for this drug in the US is
acetaminophen. Pethidine, the generic name for Demerol is meperidine.
ASA (acetyl salicilic acid) is called aspirin in the US. Therefore,
using as many names as we know will make communication easier in this
international discussion.
Bonnie Jones, RN, ICCE, IBCLC
from the sunny S.W. USA
=========================================================================
Date: Fri, 1 Jan 1999 19:44:55 -0700
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: The Jones Family <[log in to unmask]>
Subject: Milk storage in the NICU
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If there are NICU moms pumping 9-12 oz. every 3 hours, don't they need
to be instructed in reducing oversupply. The baby will probably NEVER
need that much milk. Also, how is this affecting the percentage of fat
in the milk baby is getting?
Other opinions on this issue?
Bonnie Jones, RN, ICCE, IBCLC
from the sunny S.W. USA
=========================================================================
Date: Fri, 1 Jan 1999 19:45:14 -0700
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: The Jones Family <[log in to unmask]>
Subject: Bulb syringe germ
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I think the pathogen my friend said grows in bulb syringes in
pseudamonas (sp?).
Bonnie Jones, RN, ICCE, IBCLC
from the sunny S.W. USA
=========================================================================
Date: Fri, 1 Jan 1999 21:49:50 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Carol Brussel <[log in to unmask]>
Subject: singapore connections
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is anyone in singapore that could help me with information about a lab to do
blood tests for a woman in malaysia who needs allergy tests run? email me
privately please.
carol brussel IBCLC
=========================================================================
Date: Fri, 1 Jan 1999 20:55:32 -0600
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Jill Lund <[log in to unmask]>
Subject: f/u on Cathy's rant
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Cathy -
I enjoyed your rant. From my talks with WIC moms, I don't necessarily
think doctors are always saying directly that the baby is allergic to their
milk (although I know it does happen), but I do think that is the message
they are picking up. Like you said -- the most vulnerable moms -- the ones
who get messages that they are no good are the ones most likely to say
something bad about their own milk.
One day I had a mom who was told to stop bfing for 1 day because of
jaundice. I went to the doctor and I said, "Ms. Blue now thinks her milk
is bad." Our clinic doctor said, "I didn't tell her that her milk is bad."
I said, "Do you understand that because of what you said to her, she
thinks her milk is bad?" The doctor repeated her line, and then I repeated
mine, and then the doctor was silent. It had sunk in. (baby steps)
We are now asking our moms on prenatal questionnaires: **"What have you
heard about breastfeeding?" AND "What have you heard about formula?" The
answers can be astonishing.
I've started to ask clients: "Where does formula come from?" -- clients
often do not know. The 3 step counseling prenatally is helping (an open
ended question like **, VALIDATE mom's feelings, then educate on her
concern or barrier to breastfeeding).
I was so frustrated with postpartum moms that would not even think about
trying breastfeeding that I did a mini-study in the clinic when they came
to get their formula. I first let them know I was not going to talk them
into breastfeeding, I just wanted them to help me out. My question was:
"If I could give you anything you wanted, anything (obviously a
hypothetical!) .. what would it take for you to just think about trying
breastfeeding?" (I had to encourage most of them several times to give me
an answer - shocked as some moms can be that we are still talking about
breastfeeding at a formula pick-up in WIC)
All of the moms I asked (except 1 who wanted money) said JUST SOMEONE TO
HELP THEM LEARN HOW TO BREASTFEED (I mean really help them... Many of our
moms know from talking to one another that there isn't the kind of support
they need to jump from formula feeding family to breastfeeding family in
the hospital. The fact that we have had moms wait until they get home to
try breastfeeding tells me how little love and care is given to them at
times in the hospital -- at home too) I've had an LC nurse complain to me
that our moms ask too many questions in the hospital and need too much help
or that a phone call is good enough or even that they have all those family
members in their room {can you believe that one?}. I could cry - in fact I
have.
How far is a first generation breastfeeder going to make it with all these
odds? The beauty of bfing is that it can mean so much in the life of
anyone, and many of our moms keep on in the face of all odds. They make it
in spite of professional misinformation or professionals with elitist
attitudes about breastfeeding or coworkers or family members who tease them
in not very nice ways. (& lots of our moms see carnation ads daily -- and
we give out formula vouchers -- working for change from within the system
just like those of you working at hospitals that are not baby friendly yet)
A little bird told me that I was referred to as a breastfeeding something
or other in a management meeting. After that I set up meetings with every
management person in that meeting, and I showed them the "National WIC
Breastfeeding Promotion Campaign videotape." I asked them to wear a gold
ribbon at work to support the campaign, and to my face not one of them
turned me down. (baby steps)
I went to a workshop (not bfing related) and a woman told me she had
spoken to some of the elder women of a tribe, and she had been told that
for the world to get better, women were going to need to take back their
voices. Women were going to need to speak up. Every once in awhile I
think of that because although it can be hard to speak up, our guts tell us
it is really harder to stay silent.
And the rant goes on.....
Jill Lund, St. Louis, Missouri, WIC
----------
> From: Cathy Bargar <[log in to unmask]>
> To:
> Subject: tangential rant
> Date: Friday, January 01, 1999 4:51 PM
>
> <<How long until we start hearing doctors telling
> moms that they need the Prolina formula because their babies are
> breastmilk-protein intolerant?>>
>
> Hey, in the community where I work I hear all the time (like several
times a
> day, on a busy WIC clinic day!) that "The doctor" (and it is always the
> doctor, BTW - I've never heard this attributed to any other HCP) "said
that
> my baby is allergic to my breastmilk, so I should switch to formula."
When I
> talk with them about that concept (like how do you think the human race
> would still be here if we were allergic to our mothers' milk? Do you ever
> see other mammals that are allergic to their own mothers' milk? - This is
> big dairy country here, so lots of folks know a lot about cows, which I
> think actually really helps our BF rates.), often the moms can see how
much
> sense that idea makes. But when the words carry the authority of coming
from
> "the doctor" (or even more sacred "my baby's doctor"), it takes a
skillful
> touch to suggest that there might be other ways around "the problem"
(which,
> BTW, is usually not what you'd call a problem - most often seems to be
young
> new moms who don't really know what life with a baby can be like, & who
> think that a "good" baby is one who sleeps through the night immediately
on
> return home from the hospital.)
>
> Well, I didn't mean to work into a full-blown rant here, but I might get
> there...What really makes me blow my top when I hear this is that I only
> hear it from the most vulnerable women - women who are young, poorly
> educated, not well-supported for breastfeeding, parenting, or anything
else.
> I know these docs who say this to these poor young girls, and I can no
more
> imagine them saying such a thing to one of our Cornell faculty or their
own
> colleagues' wives than I can sprout wings and fly to the moon! Now, if
what
> the doctor means is "Sometimes foods in your diet can cause your baby to
> feel a little upset - let's look at how much dairy, caffeine, or whatever
> you're taking in", why doesn't he (or she, but I've never heard it from a
> she) say so?
>
> Concievably, in some cases the doc could be thinking that this woman
doesn't
> look like a prime candidate for breastfeeding to him (teenaged, maybe has
> some funny body piercings or tatoos, or less-than-excellent grammar, or
> funny hair colors, or her fingernails are dirty and she smells of
kerosene
> and smoke, or whatever...)When he sees this unpromising soul before him,
I
> think the train of thought goes like this: poor-young-funky-looking mom -
> maybe she does drugs or alcohol, certainly she smokes - shouldn't
> breastfeed - unsafe for baby for her to even try - formula's easier (and
she
> can get it at WIC). To attribute the best of all possible motives, I'm
sure
> that the doctor is concerned for the baby's well-being, and in his mind
> formula will just be simpler and more reliable; because, after all:
> you know what's in it (well, we know what the formula company puts in it,
> which doesn't necessarily translate to the concentration the baby gets it
> at, and it certainly doesn't speak to the conditions of dubious water
> supply, or to the storage conditions or what else has been in that
bottle,
> but he thinks he knows what's in it)
> you can measure it (well, if you can read the instructions, and do the
> calculations, and figure the fractions, and read the markings on the
bottle,
> and have a good enough grasp of time & temp.that the stuff hasn't been
> sitting on the dashboard of the car in hot weather for long enough to
spoil)
> "other people can feed the baby" (that is, of course, if this poor soul
has
> anyone around who's responsible and concerned enough to be willing to do
so,
> although if she were surrounded by so many well-meaning caretakers would
she
> be in this "dangerous" situation at all? And is relieveing her of her
> obligation to care for her baby really the most effective way to help her
> develop the bond she'll need to help her turn into a good mother?)
>
> Oh, please stop me, now I'm ranting for sure...
>
> My point is, if these are the worries behind the doctor's telling her
that
> her baby is allergic to her breastmilk, EVEN IF all these concerns are
legit
> in a given situation, this is absolutely not the way to deal with the
> concerns. An MD, or RN, or IBCLC, or social worker, or a nutritionist, or
> any other HCP has an obligation to follow up if s/he is concerned for the
> baby's welfare. We also have the obligation to share accurate and
> appropriate info with our patients/clients, in terms they can understand.
> And if a physician truly believes that the baby is allergic to its mom's
> milk, we REALLY have a problem! But just because a woman doesn't present
> herself like Martha Stewart in a nursing bra and Madeline Albright all
> wrapped into one does not excuse saying such a goofy thing to a patient!
>
> Now see what that article about the soy proteins made me do! And now my
back
> hurts from sitting at this damned computer too long - and it's all THEIR
> fault, I just know it is!
>
> Cathy Bargar
>
=========================================================================
Date: Fri, 1 Jan 1999 21:56:56 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: T Pitman <[log in to unmask]>
Subject: Vitamin D
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My comment on this study is - I hate it when they refer to babies nursed for
more than maybe six months or a year as "prolonged breastfeeding." I have
seen this same expression in many places, and to me it has the connotation
that weaning at six months would be "normal" breastfeeding and anything much
longer than that is somehow abnormal, too long, etc.
Teresa Pitman
LLL Leader, Oakville, Ontario
=========================================================================
Date: Fri, 1 Jan 1999 22:58:15 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Margery Wilson <[log in to unmask]>
Subject: Re: pumping as the second line of tx for engorgement
Mime-Version: 1.0
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My MLCA friend, Cindy Turner-Maffei [Hi, Cindy! I miss
seeing you!] lamented:
"It sounds as if pumping may have become the second line
of treatment after application of hot/cold for many
practitioners. Why is this--where is the baby in the midst of
all this treatment?"
To which I reply: AIN'T IT THE TRUTH!?!
Pump marketing has been as subtle and effective as formula
marketing. I see pumps listed on layette lists in magazines
aimed at pregnant women. Most of the prenatal patients I
see ask me about which pump they should have on hand
before the baby arrives :-0
Patients who call me about engorgement often tell me their
doctor, or a hospital nurse, or a friend, told them to get a
pump. (I hear the same thing from women with mastitis, who
get the impression from their HCPs that they should pump
after the baby nurses on the mastitic breast -- lest a drop
remain in the breast?).
I've always had positive results by treating engorgement with
cryotherapy and massage/hand expression. Even when a
woman can't express any milk she can usually massage to
the point where the tissue is "soft" enough that baby can
latch. My message to women is "get the baby to help you."
Now, I KNOW there are times women need pumps in the
early days. However, for most women, in most engorgement
situations, IMO it sends the wrong message when we tell
them they need technology to conquer a bump on the
breastfeeding road. I try to find ways to bring new moms to
see the baby as a solver of breastfeeding issues ("Let the
baby be the Captain.")
Some women later admit their partners stepped up to the
plate to help with engorgement...but that is another subtopic
;->
Technology is seductive. Be strong. Resistance is not
useless.
Margery Wilson, IBCLC
(Not really a Luddite)
in freeeeezing Cambridge, Massachusetts
Happy 1999 to all!
=========================================================================
Date: Fri, 1 Jan 1999 18:57:40 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: G Hertz <[log in to unmask]>
Subject: a wise woman - oral defensiveness
Comments: To: [log in to unmask]
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Ann writes:
Anyone working in a hospital should grab all the teaching moments they can,
and after a period of time, the results will be coming back,...
BEAUTIFULLY SAID! This is so true!!! Now if we all print this out and
post it in our lockers...
Ann, you're a wise woman.
Gail
Gail Hertz, MD, IBCLC
Pediatric Resident
author of the little green breastfeeding book - disclaimer: owner of Pocket
Publications
=========================================================================
Date: Fri, 1 Jan 1999 20:52:30 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: G Hertz <[log in to unmask]>
Subject: umbilical cord answer
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The umbilical cord answer has to do with a condition called "polycythemia".
[poly=many cyt=cells emia= blood] The "many cells in the blood" translation
is referring to what we measure with a blood test called a "hematocrit".
A hematocrit is a number that tells us what percentage of the blood is
made up of red blood cells - those concave red disc-shaped cells that carry
oxygen to the tissues of the body.
Not enough red cells is called "anemia". Too many red cells is
"polycythemia". In terms of actual numbers, the average hematocrit of a
term newborn is 60% at 2 hours of age, 57% at 6 hours old and 52% at 12
-18 hours. By the numbers - 65% is technically polycythemia and many docs
treat at 70% whether the baby is clinically symptomatic or not.
So if some is good - why isn't more even better?
1. Efficient Oxygen transport - the job of the red blood cell - decreases
above 60% and drops drastically after 70%
2. Blood flow decreases as hematocrit increases
3. Viscosity increases as hematocrit increases leading to blood "sludging"
The combination of 1, 2 & 3 cause problems with "thrombosis" which is blood
clotting where it's not supposed to.
This happens primarily in "capilary beds" which are networks of tiny blood
vessels - these can cause serious problems with areas like the brain, the
kidneys or the adrenal glands.
This leads to tissue hypoxia and acidosis - which means the tissues don't
get enough oxygen and release chemicals into the blood. Definitely not
good.
How do umbilical cord procedures lead to polycythemia?
1. Delayed clamping of the cord causes a higher volume of blood to enter
the baby - the problem is greater, the smaller the baby. [The plasma
(liquid) part of the blood can pass through the vessel walls but the red
cells stay in the vessels.]
2. "Stripping the cord" - that is squeezing the cord blood into the baby
has the same effect as 1.
3. holding the baby below the mom at delivery - same effect as 1 again.
4. note - if you've ever heard of "twin-twin transfusion" that's when one
twin gets too much blood -is polycythemic and the other becomes anemic - an
oversimplification but related in kind.
The "extra blood" is also tied to maternal - fetal transfusion in some
cases and an increased risk of jaundice from the breakdown of all the extra
cells as was mentioned in an earlier post.
Babies with polycythemia often look "ruddy" and dark pink in color.
Gail
Gail Hertz, MD, IBCLC
Pediatric Resident
author of the little green breastfeeding book - disclaimer: owner of Pocket
Publications
=========================================================================
Date: Sat, 2 Jan 1999 00:00:23 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Kathleen Bruce <[log in to unmask]>
Subject: interesting website
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This may have been mentioned before, and I might have missed it. Check out
http://pslgroup.com/dg/31702.htm
for a misguided piece of information.
Kathleen
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet,TLC, Indep. Consultant
Williston, Vermont, where temperatures are in the single digits....
mailto:[log in to unmask]
LACTNET Archives http://library.ummed.edu/lsv/archives/lactnet.html
=========================================================================
Date: Sat, 2 Jan 1999 00:06:01 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Kathleen Bruce <[log in to unmask]>
Subject: oral defensiveness, a vignette
Mime-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
Just yesterday, I worked with a mother and baby. Difficult delivery. Lots of
suctioning.
Baby absolutely refused to suck on a finger for an exam, even when offered,
and not pushed on the baby. When baby did finally accept the gloved finger,
the baby gagged very easily and quickly, as opposed to other babies I have
examined.
Even oral exams can be an intrusion on some babies, depending on the level
of oral stimulation that has occurred. I think it is Kittie Franz who might
have said that she always offers a finger for an exam, but that it is very
important to not assault the baby by forcing.
I personally think that if someone suctioned me, I'd be WAY defensive
myself. Babies who have been suctioned are often not eager to breastfeed
afterwards. IN MY OPINION.
Kathleen
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet,TLC, Indep. Consultant
Williston, Vermont, where temperatures are in the single digits....
mailto:[log in to unmask]
LACTNET Archives http://library.ummed.edu/lsv/archives/lactnet.html
=========================================================================
Date: Sat, 2 Jan 1999 00:04:54 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: G Hertz <[log in to unmask]>
Subject: whose blood is it?
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A quick note since this has come up a few times....
In theory, the blood in the "placental curcuit" belongs to the baby - the
moms blood in the uterine vessels interfaces with the baby's blood through
diffusion, etc - but not by direct mixing.
However, in practice some maternal fetal transfusion can occur. The test
to evaluate this is the KB [Kleihauer-Betke stain] test which looks for
maternal cells in the newborn's circulation.
The scenario where this is most common is with precipitous delivery,
placental abruption, placenta previa, tetanic labor or manual removal of
the placenta. It can also occur during version [turning the baby inside
the mom - done from the outside]
Gail
Gail Hertz, MD, IBCLC
Pediatric Resident
author of the little green breastfeeding book - disclaimer: owner of Pocket
Publications
=========================================================================
Date: Sat, 2 Jan 1999 00:26:16 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "W4 [log in to unmask]" <[log in to unmask]>
Subject: NICU Milk supply
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I do not like to encourage a large oversupply of milk for NICU infants.
I think careful watching of NICU moms milk supply is desirable, for several
reasons. One, is that it is unnecessary for her to waste that energy if she
has an oversupply. It is a stress to have a baby in the NICU.
Two, is that oversupply may predispose her to mastitis, which loves to visit
moms with exhaustion and stress.
Three is that putting a baby to the breast of a mother with oversupply
overwhelms the baby with foremilk, and interferes with the whole meal at the
breast process. They don't get a whole meal when they are real tiny, but it is
a goal by 4 pounds or so, and a four pounder doesn't need 12 ounces!
A fourth and final reason is that when baby gets frozen milk, it is good to
get a full complement of milk, without a lot of lactoengineering.
It is better to keep the supply at a little on the high side, and it is
important to prevent undersupply with early initiation and troubleshooting.
With careful pre-at-the-breast management, and attention to details as baby
learns to go to the breast, these babies go home breastfeeding for months and
months.
It's a lot of effort but well worth it, so the families report, and their
health record supports the economic benefits.
Fritzi Drosten, RN IBCLC
Piedmont, CA
=========================================================================
Date: Fri, 1 Jan 1999 23:27:56 -0700
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Eric Jaschke/Leslie Ayre-Jaschke <[log in to unmask]>
Subject: Re: Vitamin D
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Teresa wrote:
>My comment on this study is - I hate it when they refer to babies nursed
for
>more than maybe six months or a year as "prolonged breastfeeding." I have
>seen this same expression in many places, and to me it has the connotation
>that weaning at six months would be "normal" breastfeeding and anything
much
>longer than that is somehow abnormal, too long, etc.
I agree, and posted a message to this effect in response to the article. It
will be interesting to see if I get any comments.
Leslie Ayre-Jaschke, BEd, IBCLC
Peace River, Alberta, Canada
[log in to unmask]
=========================================================================
Date: Sat, 2 Jan 1999 00:28:21 -0700
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Jerry & Jacie Coryell <[log in to unmask]>
Subject: Re: NICU pumping
MIME-version: 1.0
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I disagree with Bonnie about moms being told to decrease pumping and
production. I've seen happen over and over, after about a month in NICU and
big volume of milk due to pumping, mom has a decrease in the volume. This
decrease is from several things: 1) she gets tired of pumping and slowly and
unconsciously goes from a very specific pumping schedule to a more loosely
followed schedule, or rather than every 2 1/2 to 3 hours, she stretches it
to 3 1/2 to 4 1/2 hours; 2) mom doesn't pay as much attention to rest, food,
fluids like she did right after the birth, and doesn't have the support
that she had, sort of "your baby is in the hospital, still? So get a life"
attitude from family and friends and employers; 3) the friendly nurse who
says "I don't think we'll ever be able to feed all your milk to the baby,
you just have soooooo much" which gently tells mom to cut back. I
personally prefer to encourage her to keep her production high because these
happen almost every time. I would NEVER tell a mom she's producing too much
milk! Also, I think it was Dr Neifert who spoke about a normal drop in
production at about 1 month. I don't have a reference for that, but she
said it at a conference in Albuquerque several years ago and I believe there
is a reference.
Jacie in Albuquerque, who shouldn't be on the computer at midnight, but
can't resist checking e-mail before going to bed!
=========================================================================
Date: Fri, 1 Jan 1999 23:45:34 -0800
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Janet Simpson <[log in to unmask]>
Subject: Re: NICU moms and oversupply
Mime-Version: 1.0
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Hi All,
Bonnie writes:
>>If there are NICU moms pumping 9-12 oz. every 3 hours, don't they need
>>to be instructed in reducing oversupply. The baby will probably NEVER
>>need that much milk. Also, how is this affecting the percentage of fat
>>in the milk baby is getting?
>>Other opinions on this issue?
First of all, great question!
My opinion is this:
Why the baby is in the NICU and how long the baby is going to be there play
an important role in deciding if the mom should worry about an oversupply or
not.
If mom has a 30 wk +/- baby in NICU then she should not even concern herself
with oversupply as being a problem. In fact it is preferable at that point,
imnsho, because so many moms seem to begin having supply probs around 6wks
into full-time pumping. Almost every mom I worked with whose baby was not
at breast and feeding well within a few weeks had some sort of supply
problem occur around 6 wks, sometimes earlier, sometimes later. Some had a
catastrophic failure of production and were unsuccessful at regaining their
supplies, others were able to stave off compleate loss with herbs or reglen
(we don't have domperidone here). These moms were very religious about
their pumping regimine, btw. The ones who had an oversupply and had tons of
back-up milk stored in their freezer (and their families freezers, and even
mine at one point!) were thankful that even tho their milk production had
ceased (even with heroic efforts to get it back) they had several weeks or
months worth of EBM stored so that their baby did not have to receive ABM
any time soon. The moms who did NOT have oversupply "problems" were greatly
distressed because they did not have enough of their own milk left over and
their babies had to be put immediately on ABM.
I encourage my moms to bring in a healthy milk supply if their baby is going
to be in the hosp for a while. So many things can affect the milk
production (stress is a BIG one, as is exhaustion), so why take any chances?
The better the milk supply the longer baby will get breastmilk. If baby
comes home, is BF well, and mom is now having probs with oversupply, no
problem. We can take care of that fairly easily. I tell my moms it is
better to have an oversupply, than an undersupply. They all agree with that
one! Another thing I do is tell the mom that the second she notices any
change in the amount of milk she gets (getting less) to call me so we can
discuss what is going on in her life at that moment (not getting enough time
to pump, too much stress, no support, supply is dropping with no obvious
cause) and discuss ways to aleviate that challenge and increase the supply
again.
The only reason I can think of for a mom to have supply probs around 6 wks
or so, is that the pump does not take milk from the breast the way the baby
does (there is never the complete stimulation or drainage that a baby can
give) so the breast just little by little produces a bit less, until there
is a marked, noticeable change in supply. Am I off base here, or is this a
rational thought process? (it is late and I am very tired, but where am I??
Obviously NOT in bed sleeping! :D )
As to the percentage of fat the baby is getting, I don't see that as a
problem. The percentage is probably the same as if the supply was exactly
what the baby needed. There is no foremilk/hindmilk imbalance because both
breasts are being "drained" (I hate that term...) by the pump and the
hindmilk comes along with the foremilk, unlike a fm/hm imbalance where the
baby gets too much FM and not enough HM because s/he is not spending enough
time on one breast to get to the HM.
OK, those are my opinions...hope I made sense! Someone correct me if I got
something off base, please!
TIA!
Jay
Jay Simpson, CLE
Sacramento (State Capital), California, West Coast, USA
"No Miracles performed here, just a lot of love and hard work."
=========================================================================
Date: Sat, 2 Jan 1999 07:04:49 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Linda Barrett, LLL Leader" <[log in to unmask]>
Subject: Re: Baby removed from mom's custody
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Karen,
I have had the misfortune to have had to work with this type situation before.
In each and every case there were circumstances that the mother did not relay
to us which made the baby's removal from the family necessary. My
recommendation is to tread lightly and continue to gather information.
You, mother or her attorney can contact La Leche League. They have a
Professional Liason department that has vast stores of legal information. Her
attorney will also be able to gather the references needed. There are LLLLs
and IBCLCs who will testify if need be but will undoubtedly need to be
assuared that the baby is not in danger of any kind.
Good luck!
Linda
=========================================================================
Date: Sat, 2 Jan 1999 07:42:39 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Patrica Young <[log in to unmask]>
Subject: Re: breastfeeding poll
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Dear Katie, I went and voted. Interesting site. "We won't take
advertisements (or other business) from companies that make products that
may be harmful to your baby's health." from statement of philosophy then
they proceed to sell bottles! I looked fairly carefully and found no
formula ads tho. As I said interesting. Has a bulletin board, with one
part discussing a TX mom asked to not nurse in a restaurant by police
officer and how she handled it. In the "you go girl!" category. Sincerely,
Pat in SNJ
> vote (and comment) in the breastfeeding poll:
>
> http://www.babycenter.com/live/poll.html?id=1545
=========================================================================
Date: Sat, 2 Jan 1999 08:22:33 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Kathleen Bruce <[log in to unmask]>
Subject: careful..administrative post
Mime-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
Good morning. Can we please use quotes from prior posts sparingly? Please
don't quote an entire digest..etc.
Thanks.
Kathleen
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet,TLC, Indep. Consultant
Williston, Vermont, where temperatures are in the single digits....
mailto:[log in to unmask]
LACTNET Archives http://library.ummed.edu/lsv/archives/lactnet.html
=========================================================================
Date: Sat, 2 Jan 1999 08:18:25 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Patrica Young <[log in to unmask]>
Subject: Re: Pat's grandbabies
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Cathy, I have 14 (12 BF and 2 poor dears bot fed). 12 nat deliveries - 2
with epidurals - guess :-) They range in age from 3 mo to almost 18. The
one in college was homeschooled and is ahead of herself. Did college
courses at local community college during her senior HS year and started
college with one semester done. She told me the other day that her first
semester away is a 3.1, which I think is great considering she is far away
from home for the first time in her life. Of course she was BF 2+ years!
You have to understand that I adopted my first child(who will be 40 this
year) at the age of 2 1/2 - I was precocious - what can I say :-) Actually
I was 18 when I had her in 1959 Ack now you all know that I'll be 58 next
mo. Nursed her for 2 1/2 weeks, which is probably amazing for 1959! She
has nursed all her 3 babies for 2 + years and worked(!) My five kids are
29-39 with birthdays starting in May. Sincerely, Pat in SNJ
=========================================================================
Date: Sat, 2 Jan 1999 08:28:51 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Patrica Young <[log in to unmask]>
Subject: Re: Levels of skill acquisition
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" I "recognized" what you were saying - I can get to the
> nitty-gritty in various situations very quickly (for instance I really
like
> working with low weight gain and FTT situations) but go running to the
> books, or seek other opinions on Lactnet when I'm not sure
going backwards and forwards between levels of skill, depending on
> actual experience."
This person communicated privately with me and brought up a point that is
worth mentioning. If you see lots of babies with tongue--tie (like
Allison- they gravitate to her practice) or preemies because you are an LC
in a NICU, you do become much more "expert" in these areas and maybe you
are a novice when it comes to baby with FTT at 3 mo. We all tend to zoom
in on an area that interests us or that we have more experience with. Some
are generalists and are comfortable in many varied situations. It just
depends on how much exposure you get to one thing or another. The
important thing is that we know when we DON'T know and we DO know who to
ask! ie: recognize our limitations instead of bluffing thru, which I think
some HCPs do because they are "supposed" to know it ALL. These are the
people who say wean at the drop of a bottle - they know that answer and it
is "safe".Sincerely, Pat in SNJ
=========================================================================
Date: Sat, 2 Jan 1999 08:41:01 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Patrica Young <[log in to unmask]>
Subject: Re: Milk storage in the NICU
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"if there are NICU moms pumping 9-12 oz every 3 hours, don't they need to
be instructed in reducing oversupply"?
I believe the quality and quantity of the milk supply at 6 weeks and later
on is dependent on an excellent supply initially. So if we only asked
these breasts to produce the incredibly tiny amount needed originally for a
preterm baby, by the time the baby gets bigger mom will still be making
tiny amounts. I think it is much easier to slow a supply down a little
than to boost it when the baby is older. The extra milk can go to milk
banks. I believe Dr. Mom talks about the full hydrant idea for preemies
and babies with heart conditions. Have the breast full and overflowing so
baby doesn't have to work too hard to get what s/he needs. An abundant
supply is a plus in these situations. Tension and fatigue play a role in
this too. Sincerely, Pat in SNJ
=========================================================================
Date: Sat, 2 Jan 1999 10:10:12 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: David Green <[log in to unmask]>
Subject: Re: Suctioning meconium
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In a message dated 12/31/98 7:53:34 PM Central Standard Time,
[log in to unmask] writes:
<< It also
deals with the proper resuscitation of a baby who has passed meconium at
some point prior to delivery. Meconium is that tarry sticky dark first
bowel movement that babies have. If and infant has been "stressed" before
birth it can cause relaxation of the anal sphincter and meconium flows into
the amniotic fluid. Babies do "breathe" amniotic fluid in utero and a
distressed baby may have "gasping" respirations. >>
I trained when we would use an endotrachial tube to suction a meconium baby
and we would usually place a piece of gauze over the end of the tube and
suction by MOUTH! Sometimes you did not have time to put the gauze over the
end and you would sometimes wind up with a mouth full of meconium! Now that
is "psycho-oropharyngeal-trauma" - more for me than the infant! <g>
Andrew MD
[log in to unmask]
=========================================================================
Date: Sat, 2 Jan 1999 10:20:56 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: David Green <[log in to unmask]>
Subject: Re: orally defensive baby
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In a message dated 12/31/98 7:53:34 PM Central Standard Time,
[log in to unmask] writes:
<< Now you know why it's done - the stakes are very high.
An orally defensive baby - I had two particularly difficult ones this month
- is going to do better on breastfeeding in my nursery with LC help than if
he were intubated and on a ventilator in the NICU for a week. >>
From a medical standpoint, it is better to have a live & "healthy" baby who is
orally defensive than a sick, intubated baby who does not have the "chance" to
be orally defensive, if you know what I mean. That is one reason why I have a
hard time seriously accepting some of the "psycho-trauma" stuff due to
suctioning. Another reason is that when I think about all the "trauma" that
an infant suffers from being born (albeit natural), it is really hard to
seriously accept that properly-done suctioning of an infant's naso-
oropharyngeal space, airway and stomach for "real" medical reasons is somehow
going to cause some sort of weird psycho-oro-mental-cognitive anguish. Being
born, however natural, is much more traumatic than having your nose "snogged."
IMHO
Andrew MD
[log in to unmask]
=========================================================================
Date: Sat, 2 Jan 1999 15:07:11 +0000
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: heather <[log in to unmask]>
Subject: UK soaps - latest news
Mime-Version: 1.0
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I can now reveal to the world that Bianca (EastEnders) had her baby - Liam
- a week ago and she is bf! Hurrah! Tiffany came round to see her (about
an hour before Tiff' s tragic demise courtesy of Frank Butcher) with some
champagne, then has second thoughts.... 'Ooh, but if you're breastfeeding,
Bee.....' 'Nah,' says Bianca, 'a little bit won't hurt' - well said, Bee.
But - boo! - Judy (Coronation Street) has had her twins (boy, girl) and
she is already bottle feeding : ( with no mention of anything else. Last
scene I saw had her and Gary running round trying to heat up bottles and
sterilise stuff while one or both babies' yells pierce the air.
I knew you would all be agog to know these vital bits of information : )
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
=========================================================================
Date: Sat, 2 Jan 1999 10:33:36 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: David Green <[log in to unmask]>
Subject: Re: brutal?
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In a message dated 12/31/98 7:53:34 PM Central Standard Time,
[log in to unmask] writes:
<< As I recall not too long ago it was standard practice to operate
on babies (i.e., open heart surgery) with out anesthetic *because babies
can't feel it*. Just because most folks can't consciously remember
their infancy is no reason for it to be OK to be brutal to infants. >>
Well, it was not too long ago that anesthetic agents presented greater risk to
the infant than what procedure was being done to them. In pediatrics, we
don't like the cure to be worse and/or a greater risk than what we are trying
to cure!
It is easy to look back and criticize past medical practices in the light of
current knowledge and technologies.
Perhaps we should be as critical of neolithic birthing & medical practices
when over 50% of infants born died before they reached one year of age. But
hey, it was natural even though fatal at times. Medicine and medical
procedures may seem cruel at times in our "civilized" thinking; however,
nature can be much more brutal than we care to admit.
Andrew MD
[log in to unmask]
=========================================================================
Date: Sat, 2 Jan 1999 10:47:31 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: David Green <[log in to unmask]>
Subject: Re: suctioning again
Mime-Version: 1.0
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In a message dated 12/31/98 11:07:01 PM Central Standard Time,
[log in to unmask] writes:
<< I suspect that if physicians who doubt the oral aversive possibities of
suctioning tried it, they would be equally amazed at the annoyance
potential and may find a more gentle suctioning manner. >>
Nobody likes nor enjoys have their nose "snogged" - human nature.
Infants don't like it, toddlers don't like it, children don't like it. Why
heck, even adults don't like it. I have the hardest time getting adults to
"irrigate" their noses for nasal congestion/allergic rhinitis......it is much
much more effective and natural than all the pills/herbs in the world but they
just won't do it! It's not "pleasant." Perhaps if adults had their noses
snogged & irrigated, they would become more oral aversive - not a bad idea now
that I think about it! <g>
Andrew MD "going to irrigate my nose right now!"
[log in to unmask]
=========================================================================
Date: Sat, 2 Jan 1999 11:17:46 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: David Green <[log in to unmask]>
Subject: Re: Birthing interventions
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In a message dated 1/1/99 9:45:06 AM Central Standard Time,
[log in to unmask] writes:
<< We create the problems with birthing
interventions and then cure it with nursery interventions. 10 of my
grandchildren have been delivered by midwives, 12 babies with not one drop
of drugs. I think it makes a BIG difference. The latest was born with
epidural and desatted (turned blue) with first bottle and went to NICU for
3 days - need I say any more? >>
Well, go visit an "old" cemetery and count the infant graves and then go to a
"new" cemetery and count the infant graves. Need I say more?
Perhaps we should go back to the prehistoric "good ole days" when more than
50% of infants did not make it to one year of age.
To paraphrase a famous quote: Those who do not know their history are doomed
to repeat it.
Your study of one out of 12 is hardly proof of anything.
IMHO
Andrew MD
[log in to unmask]
=========================================================================
Date: Sat, 2 Jan 1999 11:25:05 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: David Green <[log in to unmask]>
Subject: Re: suctioning again
Mime-Version: 1.0
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In a message dated 1/1/99 9:45:06 AM Central Standard Time,
[log in to unmask] writes:
<< 3. If suctioning isn't irritating/annoying/traumatic/unpleasant, why do
babies object to it so strenuously? >>
Geez, some babies strenuously object to me examining their eyes for a red
reflex and, heck, just to make sure they are there!
Many babies strenuously object to me examining their hips for developmental
dysplasia of the hip but I will be damned if I don't do it anyway.
I simply mutter to myself: "I think thee protesteth too much!"
Andrew MD
[log in to unmask]
=========================================================================
Date: Sat, 2 Jan 1999 11:34:45 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Sheila Humphrey, B.Sc.(Botany) RN IBCLC" <[log in to unmask]>
Subject: hot and cold
Comments: To: [log in to unmask]
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Hi Rhoda and Lactnetters,
Read the lactnet post about alternate hot-cold treatment for engorgement with
much interest - I have certainly heard of hot and cold applied alternatively
as my much older sister has described her experience with it many times.
She gave birth in Hope, British Columbia in 1967 and suffered terrible
engorgement until an "old English nurse" took her in hand. The nurse prepared
2 basins - one with as hot as one can stand hot water and the other with ice
water. Then she instructed my sister to lean over and plunge her breasts
first into the cold and then into the hot, then repeat and repeat ( all rather
theatically carried out with absolute faith on the part of the nurse) with
quick alternations until the milk started to flow. My sister experienced
immediate relief of pressure as the milk poured forth, apparently in great
volume.
Then my little nephew was able to latch and nurse, which my sister is extemely
proud to claim for 9 months ( which she considered a very long time, and in
that time and place it was).
Have never heard anything akin this technique until you posted a somewhat more
civilized version that that my sister went through, but with the same
immediate results! Anyone up for an explanation of this???
The sacred cows must be shuddering in their udders.
Happy New Year.
Sheila Humphrey
BSc RN IBCLC
=========================================================================
Date: Sat, 2 Jan 1999 11:43:50 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Carol Brussel <[log in to unmask]>
Subject: oral defensiveness
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our list mother states:
<< Babies who have been suctioned are often not eager to breastfeed
afterwards. IN MY OPINION. >>
this is not "your opinion" - it is your professional observation. i seem to be
spending more time in hospitals than i had anticipated when i started doing
this, and it is quite interesting, but it definitely seems that all the
"normal" procedures are quite destructive to breastfeeding success, and the
suctioning and other procedures that can cause oral defensiveness - DO cause
it. especially bottling babies.
just my professional observation as well.
carol brussel IBCLC
=========================================================================
Date: Sat, 2 Jan 1999 11:50:36 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Carol Brussel <[log in to unmask]>
Subject: oversupply "problems"
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there is no such thing as an oversupply of milk; it is just in the wrong
place. in other words, if the mother pumps so much milk that she never needs
it (and as jay pointed out, it is so easy for breastfeeding to fail, think
about the interventions and ask me about the clients i have right this minute
whose babies won't or never have breastfed after being in nicus), there are
milk banks that know what to do with it.
i also think that saying that milk production requires energy is incorrect,
and sounds just like the justification for giving babies tubes or bottles in
the nicu - "it takes too much energy for him to breastfeed, let me just give
him the milk in the volufeeder and get him back in his isolette." i would
never try to change a mother's supply downward in the first four to six weeks,
anyway, without some sort of clear sign that something was grievously wrong.
feed the baby, protect the milk supply.
carol brussel IBCLC
more knowledgeable every day about nicus (here is where the upsidedown smiley
face emoticon goes)
=========================================================================
Date: Sat, 2 Jan 1999 11:58:26 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Jan Barger RN, IBCLC" <[log in to unmask]>
Subject: hot vs. cold
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Cindy writes:
<< Another question arises from reading this wonderful group think on
engorgement: why is pumping mentioned so often as an engorgement
treatment? It sounds as if pumping may have become the second line of
treatment after application of hot/cold for many practitioners. Why is
this--where is the baby in the midst of all this treatment? >>
Pumping is used ONLY if the baby is unable to latch on to the flattened nipple
or absolutely refuses the br because he is now unfamiliar with the shape,
texture, and feel of it.
If the baby can latch on, and does, and breastfeeds effectively, certainly no
use for a pump.
BTW, went in this morning (7:30 am on a Saturday -- cruel & unusual
punishment, especially since Wheaton got hit with the first snowstorm of the
season -- let alone the year) to see my chiropractor for my painful arm. He's
been having me ice it -- so I asked him why ice instead of heat (though I
thought I knew the answer, I figured given our discussion, it would be
helpful). His response ran something along these lines. "You should never
use heat on a sports injury or any portion of the body that has swelling.
Localized heat applied to the spot brings more blood to the surface, causing
congestion, engorgement and stasis." (I thought it was interesting he used
the latter two words). He went on to say that all the newer literature stated
that heat is OUT, cold is IN. However, he did say that if someone wanted to
use total body heat, such as a warm shower, that would be OK, but hot packs to
a part of the body was not appropriate -- even 24 hours after a specific
sports injury, ice/cold need to be used to decrease the inflammatory process
that is inherent with swelling.
I mentioned lactation to him, and engorgement -- he's not an LC, but is very
familiar with the use of cabbage for swelling, and completely agrees that
localized heat to the breasts is inappropriate -- unless, he said, you use
alternating hot packs and cold packs to the breast.
OK, when I go in on Wednesday, I'll ask him about using heat for mastitis....
Jan -- still thinking, even though it is 1999.
=========================================================================
Date: Sat, 2 Jan 1999 12:04:32 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Carol Brussel <[log in to unmask]>
Subject: the trauma of being born
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okay, andrew, point well taken, so if birth is so traumatic, then all babies
need to be born by c/s, right?
(trying to point out that some events have a purpose, others should be used
only when there is a definite need - that's what natural means.)
carol brussel IBCLC
=========================================================================
Date: Sat, 2 Jan 1999 17:08:56 +0000
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: heather <[log in to unmask]>
Subject: birthing interventions
Mime-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
Andrew writes (apropos of epidurals and, by implication, routine
suctioning) : 'Well, go visit an "old" cemetery and count the infant graves
and then go to a
"new" cemetery and count the infant graves. Need I say more?'
Well, yes please...a *bit* more would be a whole lot more fair to mothers,
babies and history....such as the fact that
i) public health measures (improved hygiene, adequate sewage, clean water) and
ii) generally improved nutrition
have had a far greater role to play in reducing infant mortality in the
West than (for example) universal epidurals and routine sunctioning....
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
=========================================================================
Date: Sat, 2 Jan 1999 12:15:29 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Patrician Drazin IBCLC <[log in to unmask]>
Subject: Re: vit d
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In the Chicago are there have been quite a few cases of rickets in bf fed
babies.. I recently attended a meeting where they presented 5 cases and there
is another hopital that has had a equal no. and is now doing a study ( i
beleive)
One of the difficulties is that babys go to day care before the sun is up/
stay there inside all day and are picked up after dark.... I thinkt that this
is another area where we need to "remind" people that children should get some
outside time.
Patricia
{chicago is finally under snow/there are very heavy easterly winds and sand
bags have been lined up along the shore line to keep the lake from being blown
into the city!}
=========================================================================
Date: Sat, 2 Jan 1999 12:22:34 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Katie Allison Granju <[log in to unmask]>
Subject: birthing interventions
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In a message dated 1/2/99 12:00:19 PM Eastern Standard Time,
[log in to unmask] writes:
<< Well, go visit an "old" cemetery and count the infant graves and then go to
a
"new" cemetery and count the infant graves. Need I say more?
Perhaps we should go back to the prehistoric "good ole days" when more than
50% of infants did not make it to one year of age.
To paraphrase a famous quote: Those who do not know their history are doomed
to repeat it.
Your study of one out of 12 is hardly proof of anything. >>
Andrew:
It's certainly true that modern medicine saves *sick* babies' lives. As the
mother of a 12 month old (birthday tomorrow!) who was born last January with
persistent fetal circulation and who spent several lifesaving weeks in the
NICU (where, by the way, he never had a single bottle until the day I put him
to breast with nasal cannula still in at ten days of age), I am acutely aware
of how different things are for babies with health problems in 1999 as opposed
to 1889. And since you are on a l*st full of other medical professionals, you
can be quite sure that everyone else is too. However, to doubt that the
*routine* (meaning, not medically necessary) interventions of our
technological birthing culture are iatrogenic is to ignore the research.
Check out my article on this topic at:
http://www.goodnewsnet.org/weekly/minnesto.htm
Katie-- working at her computer today with her chronically aching, epidural-
injured back aching terribly
Katie Allison Granju
Knoxville, TN
=========================================================================
Date: Sat, 2 Jan 1999 12:31:26 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: newman <[log in to unmask]>
Subject: modern medicine
Comments: To: [log in to unmask]
MIME-Version: 1.0
Content-Type: text/plain; charset="iso-8859-1"
Content-Transfer-Encoding: 7bit
Well, Andrew, the truth of the matter is that a lot of the decrease in
infant mortality has more to do with better social conditions than medical
improvements.
By the way, the US which has the most intervening medical system in the
world, also has one of the highest infant mortality rates in the world as
well.
Jack Newman, MD, FRCPC
=========================================================================
Date: Sat, 2 Jan 1999 12:38:57 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Jan Barger RN, IBCLC" <[log in to unmask]>
Subject: "snogged?"
Mime-Version: 1.0
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Andrew comments,
<< Being
born, however natural, is much more traumatic than having your nose
"snogged."
IMHO
Andrew MD >>
How do you know?
How do you know that natural birth is traumatic? When was the last time you
saw a natural birth? There are VERY FEW in hospitals, if any -- do you attend
home births? That's about the only place you will see a natural birth any
more -- unless you attend births at out-of-hospital birthing centers (true
birthing centers, not the newest made-up, politically correct name for labor
and delivery.)
Birth was designed to be -- "snogging" the nose wasn't. It's a MAN made
design which may be needed in some cases -- no one is denying the fact that
occasionally suctioning is needed, and there isn't a one of us that would
rather have a live & healthy orally defensive baby that a dead one. Who may
be considered orally defensive. But that does NOT justify suctioning babies
who don't need suctioning. Besides with all the shoving the bulb syringes in
babies mouths & noses, how much gunk is usually gotten out? Not much of
anything most of the time. If the baby is gagging, but getting it up on his
own, how much better to leave him alone and watch him than cram a piece of
equipment down his throat. If he can't get it up and is turning blue, it's
usually too far down for a bulb syringe anyway. And sometimes it isn't
anything that a bulb is going to help, but a baby who has forgotten how to
take a breath.
Jan Barger -- who firmly believes that birth does not have to be traumatic for
a baby, but who thinks it definitely is in American hospitals because of the
man-made interventions which are primarily NOT NEEDED.
=========================================================================
Date: Sat, 2 Jan 1999 10:25:43 -0800
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Kathie Lindstrom <[log in to unmask]>
Subject: Re: more on suctioning.....
Comments: To: "L-Soft list server at UMASS Medical Center Library (1.8c)"
<[log in to unmask]>
Mime-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
I think it is rather unfortunate to hear comparisons of how birth used to be
in the OLD days to justify what we continue to do today that is well known
to cause difficulty and trauma to mothers and infants. It is sad to think
that some in the medical community have a hard time seeing beyond the
physical and are stuck in the place that pregnancy, labour, birth and
parenting are physical events riddled with danger at every turn and we had
better watch out lest we not know what we are talking about - after all no
one wants a baby that's dead!! This particular line I have heard ad nauseum
as part of the control/power that is used to is used to scare parents into
conformity and submission by those that "know better". Until such time
those that have the incredible privilege of working with child bearing women
and their families, come to realize, that there is much more to this
experience than the physical, we are always going to have problems.
Problems based on fear because of past experiences, old school teachings,
fear of change and reluctance to consider another viewpoint or reluctance to
accept research and evidence that may mean a change in our own practice or
teaching. Those that are working with child bearing women and their
families need to have a belief and a trust in the process and in women and
if they don't, in my opinion, they should not be there. There is way too
much fear and anxiety that parents are exposed to through the media,
literature and well meaning friends and families, they do not need those
that purport to be "helping" them, bringing more.
I will try and not keep this going anymore, but do want it known that I do
not wear a t-shirt with a suction tube in a circle with a line through it.
I have seen many instances where suctioning was necessary but also would
like you to hear what Dr. Jack has to say about suctioning and meconium and
apnea attacks in baby's that have been suctioned as well. I have a video
(given to me by a questioning parent) that very clearly shows two apnea
attacks after repeated suctioning and then guess what? The baby is hustled
off to NICU because of breathing difficulties!! and.... two months of
breastfeeding difficulties. I wonder how many baby's are unnecessarily
traumatized and separated due to iatrogenic causes .... no I don't need to
wonder ... there are lots, way to many. The guidelines that many are
referring to actually say and teach to assess the need for suctioning - you
cannot assess a head on a perineum. If birth was allowed to follow it's
natural course, when it came TIME to assess the need for suctioning, we then
would perhaps see them used as they were intended.
You know, if we look at the things that used to be done to women in the name
of policy, protocols, routine procedures etc. ... shaves, enemas, lithotomy
positions, episiotomies, isolation, separation, supplementation etc. we have
managed to see (in most places) that these are for the most part barabaric,
unhelpful, un-woman and un-baby centered and cause more problems than they
help. These have been discontinued for the most part and we would really
question anyone that said they do these things - or I hope we would - and
more questions need to be asked and question our own practice in light of
what is normal and then go from there. If we start from the place of
normal, it will help us to better trust and learn from a process that was
perfect from the beginning.
Kathie Lindstrom
From the cold but sunny Fraser Valley in BC, Canada.
>Geez, some babies strenuously object to me examining their eyes for a red
>reflex and, heck, just to make sure they are there!
>Many babies strenuously object to me examining their hips for developmental
>dysplasia of the hip but I will be damned if I don't do it anyway.
>I simply mutter to myself: "I think thee protesteth too much!"
>Andrew MD
>[log in to unmask]
With all due respect - they doth protest for good reason. Do you ask their
permission or explain to them what you are doing and why? Perhaps they then
would not protest so much.
Kathie Lindstrom
(as above)
"this is not "your opinion" - it is your professional observation. i seem to be
spending more time in hospitals than i had anticipated when i started doing
this, and it is quite interesting, but it definitely seems that all the
"normal" procedures are quite destructive to breastfeeding success, and the
suctioning and other procedures that can cause oral defensiveness - DO cause
it. especially bottling babies.
just my professional observation as well.
carol brussel IBCLC
My professional observation as well .... I know if I am at a birth that goes
really well, with NO interventions, I will not be hangning around for weeks
trying to help the mother work through breastfeeding difficulties.
Kathie Lindstrom
(as above)
Kathie
=========================================================================
Date: Sat, 2 Jan 1999 11:18:33 PST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: laurie wheeler <[log in to unmask]>
Subject: dr. joy browne radio show/attachment parenting/not bf
Mime-Version: 1.0
Content-Type: text/plain
>Date: Sat, 02 Jan 1999 13:15:20 -0600
>From: LWheeler <[log in to unmask]>
>To: [log in to unmask]
>Subject: kids sleeping thru the nite
>
>Hello Dr. Joy,
>I listen to your program on WSMB 1350 AM radio in New Orleans on my
>commute to work in the morning. I like your advice about not dating
>married (separated) people, the 1 yr rule, etc.
>However, on Dec 30, 1998, I heard your advice to a mother of a 2 yr old
who would not go to sleep easily at 730 pm and screamed upstairs behind
the gate from 730 pm to about midnite. Your advice was to let him
continue to cry it out, even to the point of hyperventilating and
>fainting. I find that inhumane and barbarian! First, I am totally
>opposed to such treatment of children. Their needs do not stop because
we want some peace and quiet or time with our mates starting at 730 pm.
Our children need us day and nite, esp at that tender young age.
Second, some children need less sleep than others. This mom had a 3 yr
old that slept well. All kids are different, their personalities,
metabolism, activity level, interests, etc. What really got me was that
you didn't even ask if the child takes a nap or maybe even 2 naps a day
- maybe he is getting enough sleep all day! You didn't ask if maybe mom
is just getting home at 6pm and wants to put the kids to bed at 730
right after dinner! Surely the child wants to spend some time with mama
and daddy !
>Think about this - children in orphanages will eventually stop crying
>and asking for their needs to be met. They will withdraw and become
>apathetic. This doesn't mean that the treatment was appropriate. The
end doesn't always justify the means.
>Laurie Wheeler, RN, MN, IBCLC
>(my degree is in parent-child health)
>Violet LA 70092
>[log in to unmask]
>
______________________________________________________
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=========================================================================
Date: Sat, 2 Jan 1999 12:20:56 -0800
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Monique Schaefers <[log in to unmask]>
Organization: Daryll Design
Subject: Re: brutal!
MIME-Version: 1.0
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From: David Green <[log in to unmask]>
> Well, it was not too long ago that anesthetic agents presented greater risk to
> the infant than what procedure was being done to them.
While this was true some of the time it was also true that many Doctors
operated on infants without anesthetic *because they can't feel it*.
*Beacuse they can'y feel it* and *presents greater risk* are two very
different reasons. One is based in fact the other is based in personal
bias or who knows what. It took SOMEONE questioning this practice to
get it to be stopped.
> In pediatrics, we
> don't like the cure to be worse and/or a greater risk than what we are trying
> to cure!
I think this is true of most medicine but at times is unavoidable (with
the knowledge we possess now), i.e. - chemotherapy.
> It is easy to look back and criticize past medical practices in the light of
> current knowledge and technologies.
Hey! Of course it is and this isn't a reason NOT to do so. This past
isn't all that past you know!!! 20 years isn't all that long ago as
some of the grand dames on this list can tell you. I am criticizing a
current practice - rote and vigourous suctioning of infants.
> Perhaps we should be as critical of neolithic birthing & medical practices
> when over 50% of infants born died before they reached one year of age.
Of course we should and are. That's why we don't practice them anymore -
we know better now.
> But
> hey, it was natural even though fatal at times. Medicine and medical
> procedures may seem cruel at times in our "civilized" thinking; however,
> nature can be much more brutal than we care to admit.
You are right again BUT not to the point. The point is this practice of
suctioning every baby born or partially born abd doing so vigourously
and without forethought to some of the outcomes is gross, brutal, and
wrong in my not so non-medical opinion.
By the way, I for one am really happy we have you here asking questions
and speaking to issues the way you do, for several reasons. (Meaning I
see you as more mainstream than most folks on this list.) One reason is
because if we all have the same point of view and just validate
ourselves we lose a lot of potential for growth and learning. Two, you
represent many ideas I have or hold without really realizing I hold
them. I am so *very* new to this (check my signature) I realize I
really don't know anything about BFing let alone know anything *cutting
edge*. I see those initials after your name as justification for you to
be asking/raising these issues. I am always mortified I'll be politely
asked to leave when I show publically show just how ignorant *I* am.
Thank you!
--
Monique
Noah Reilly Schaefers 6/18/97
[log in to unmask]
=========================================================================
Date: Sat, 2 Jan 1999 12:23:31 -0800
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Janet Simpson <[log in to unmask]>
Subject: Pshcyo-stuff again
Mime-Version: 1.0
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Andrew wrote:
>From a medical standpoint, it is better to have a live & "healthy" baby who is
>orally defensive than a sick, intubated baby who does not have the "chance" to
<be orally defensive, if you know what I mean.
Well, of course it is better. I think we all agree on this.
>That is one reason why I have a hard time seriously accepting some of the
>"psycho-trauma" stuff due to suctioning.
You and others may have a hard time understanding this, but the baby sure
doesn't! An infant is obviously incapable of telling us with words that he
is refusing to BF because of the horrid experience s/he suffered from due to
suctioning.
I think the point here is to BE CAREFUL (for emphasis - not shouting) when
performing the suctioning. There is no reason to traumatize the infant any
more than absolutely neccessary. For some babies, the most gentle of
suctioning will be too much, and that is a risk we sometimes must take.
But, to just go in and suction like crazy and not be as careful and as
gentle as possible to avoid ANY possibiliy of oral aversion is invasive,
rude and disrespectful to the infant.
>Another reason is that when I think about all the "trauma" that an infant
suffers from >being born (albeit natural), it is really hard to seriously
accept that properly-done >suctioning of an infant's naso-oropharyngeal
space, airway and stomach for "real" >medical reasons is somehow going to
cause some sort of weird >psycho-oro-mental-cognitive anguish. Being born,
however natural, is much more >traumatic than having your nose "snogged."
Two things, the birthing process is a violent one, yes, but with a purpose.
The infant is expected to go through this process and I believe that the
human species expects to go through this inately. Secondly, we have not
been talking about "properly done" suctioning. Properly done suctioning,
even when it is medically required to be extensive, should be as
untrauamatic as possible. Sure there will be some trauma, but when proper
care is taken, it can be drastically minimized. The problem arises when
someone just goes in suctioning every open orifice without care and without
being gentle, especially when there is no medically sound reason. Why does
a stuffy infant need his nose "snogged" if he is breathing and BF fine?
Leave him alone. Let the body learn how to do its job. Also, tell anyone
(especially someone who can relate feeling to us verbally) forced to have
something shoved into their mouth and down their throat without any way to
protect themselves that their feeling of violation and anger are just
"some sort of weird psycho-oro-mental-cognitive anguish." You will probably
find their fist in your nose, giving you a weird sort of
pschoy-nasal-mental-cognitive anguish". ;) Ever have the "snot" beat out
of you as a kid? Wasn't that just a bit traumatic?
Anguish is anguish, regardless of the cause - some people are sturdier than
others and can handle traumas better - but if someone is traumatized, who
are we to judge the amount of emotional damage done to them? Is anyone who
has not been treated roughly (by anyone, for any reason, tho rape and
physical abuse stick in my mind) really qualified to say how someone who has
been abused should feel? I don't think so. One can empathise, but cannot
UNDERSTAND.
Jay
climbing off my box so I can breathe - the air is thin up there...
Jay Simpson, CLE
Sacramento (State Capital), California, West Coast, USA
"No Miracles performed here, just a lot of love and hard work."
=========================================================================
Date: Sat, 2 Jan 1999 12:28:15 PST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: laurie wheeler <[log in to unmask]>
Subject: pacifiers - ? history
Comments: To: [log in to unmask]
Mime-Version: 1.0
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Linda,
I was just wondering about pacifiers, as a result of a cousin bf and
using them. Did you find out about the history of them? Who started it?
Who invented it and why? and where?
laurie
Laurie Wheeler, RN, MN, IBCLC
Hosp LC
Violet Louisiana, USA - rainy SE USA
mailto:[log in to unmask]
______________________________________________________
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=========================================================================
Date: Sat, 2 Jan 1999 15:44:16 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Mari Douma <[log in to unmask]>
Subject: breastfeeding rubber stamps
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Kate, isn't it sweet how our children can be so generous and sharing of
something that means so much to them (since for toddlers, it's usually the
other way around-- "MINE"!). Mari Douma, DO
=========================================================================
Date: Sat, 2 Jan 1999 16:03:20 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Mari Douma <[log in to unmask]>
Subject: Bulb Syringes
Mime-Version: 1.0
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Here's my 0.02 about the use of bulb syringes at least after the first
couple of days. Don't stick that long tipped syringe from the nursery into
the baby's nose! As others have said already, this will only irritate the
tissue more and cause more congestion. If the nose really needs to be
suctioned out (yes, I would absolutely hate to have this done to me! It is
obnoxious.), I advise the parents to get the blunt tipped type (tip is clear
plastic and removable to facilitate washing). This tip does not go into the
nose but should just sit at the opening. Still an unpleasant process to be
sure but if baby is already mad because she can't breathe through her nose
and nurse...
BTW, when she about 2 y, my daughter found the bulb syringe in her drawer
and said (something like this) "here Mommy, I have to suck out your nose.
Now hold still." Yikes! I think she'll forgive me someday.
Mari Douma, DO
=========================================================================
Date: Sat, 2 Jan 1999 16:17:00 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Linda J. Smith" <[log in to unmask]>
Subject: risky interventions
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Ahh, so. The discussion of suctioning in particular and interventions in
general rages on.
Of course there is a legitimate need for SOME unpleasant/uncomfortable/risky
interventions. However, the history of medical/health care is full of
examples of procedures that were instituted because somebody THOUGHT it
would help, and only later did others demonstrate the intervention to be
unhelpful, dangerous, or even lethal. Examples include treating nausea of
early pregnancy with thalidomide, administering "twilight sleep"
(scopolamine plus morphine) for labor pain, irradiating babies' thymus
glands "to prevent SIDS," installing x-ray machines in children's' shoe
stores to check the fit of shoes, and holding newborns up by their ankles
and smacking their buttocks to make them breathe. [I am old enough to
remember early strategies for reviving drowning victims - the back-pressure,
arm lift method performed with the victim placed prone, head turned to one
side.] The first skeptics of any given "standard" procedure are usually
labeled as fanatics or worse. Now these same practices, which were "state of
the art" at one time, are rightly assigned to the Horror Files.
I, for one, am calling for careful evaluation of all known and theoretical
risks in light of the known and alleged benefits of any given procedure. If
the benefit of suctioning for a given situation outweighs the risks, of
course it's appropriate and we will have to pick up the breastfeeding pieces
afterward. However, the first step in establishing careful practice is
acknowledging that RISKS EXIST. And yes, I'm shouting about this, and YES,
there is research to back up my skepticism.
Linda J. Smith, BSE, FACCE, IBCLC
Bright Future Lactation Resource Centre
Dayton, OH USA
http://www.bflrc.com
=========================================================================
Date: Sat, 2 Jan 1999 11:09:41 -1000
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Gloria Buoncristiano-Thai <[log in to unmask]>
Subject: Birth interventions and cord (long)
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Aloha,
'Well, go visit an "old" cemetery and count the infant
>graves
>and then go to a
>"new" cemetery and count the infant graves. Need I say more?'
I need to put my .02 in here too. I don't have references to back me up
here, but I think most of those deaths occured after birth, not during
birth, due to many variables already mentioned. As I recall, the U.S.
still has a very high infant mortality rate for a western, industrialized
and "civilized" country. And don't we have all the modern medical
miracle birth interventions? Again, I believe the mortality rate here is
after birth as well.
As for those interventions, yes, they do have their place. I know I
probably sound like I am against all interventions----not true. I am
against the routine use of these interventions when unnecessary.
Again, isn't the intervention the problem with the cord blood and when to
cut? I doubt this was ever considered a problem in the past history of
humans. Now, it is. How did we survive if the cord was being cut too
late? How did we survive without abm? (Got a breastfeeding reference in
here! :D Why milk the cord? Shouldn't baby be on mom's abdomen anyway?
One last point. Sorry, I have no references here to back me. However, I
am almost certain that I read if the cord is not cut until after it stops
pulsing, the baby would get the rest of the iron stores needed to see her
through the first year. None of my children were ever anemic-----my
first did not start solids until 11 months too. No supplements either.
I was not flat on my back when my children were born and they were all
placed on my abdomen immediately. No problems experienced from them
receiving too much blood.
I could go on, but I have probably said enough already. :D
Aloha,
Gloria Thai Honolulu, O'ahu, Hawai'i located 20 degrees North of the
Equator
=========================================================================
Date: Sat, 2 Jan 1999 22:39:15 +0200
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Annelies Bon <[log in to unmask]>
Subject: birth interventions...
In-Reply-To: <[log in to unmask]>
Mime-Version: 1.0
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Just want to throw in another perspective (again!!). In the Netherlands we
do not routineously give epidurals. Women attend relaxation classes during
pregnancy that help them to cope with the pain during labor. These classes
work. Insurance compagnies happily pay for them, bc it is shown that women
who have attended these classes have shorter labor stage and need less
interventions.
epidurals are only used if necessary: eg woman has lots of pain in a
endless during delivery. but if the woman doesn't want to, she doesn't get
it.
For the first exam in her pregnancy every women goes to a midwife. That is
around 12 weeks. The midwife screens the woman, and decides if this case
need to be treated as a medical case, or as a 'normal' case. If it's a
medical case the woman goes to the gyneacologist, otherwise the midwife
controls the woman and attends the delivery. During the pregnancy women can
swap from midwife to gyn, or vice versa, depending of what happens. About
one out of three pregnancies are considered 'medical', that is, has a
higher risk than normal, and are controlled by the gyneacologist. We say: a
midwife is for normal pregnancies and normal deliveries, and the gyn is for
the high-risk pregnancies and deliveries .
A women who is controlled by a gyn, will give birth in a hospital, the
women who give birth with a midwife are allowed to choose between the
hospital (still attended by the midwife) and at home. Half of them choose
to give birth at home. Several researches have shown this is as safe as
hospital births, and are in fact a bit faster and have a bit fewer
interventions. Though the difference isn't very big.
when something happens during the delivery, eg the midwife sees meconium in
the water, the woman is transported to the hospital. This is not seen as a
failure of the births-at-home system, but instead seen as a sign the birth
system is safe: only when needed the medical system is in charge. We live
in a small countru, so 99% of all people can be in a hospital within 20
minutes.
The deliveries in the hospital either attended by a midwife or by a
gyneacologist are also pretty mother and baby friendly: woman is surrounded
by friends, if she want to, she is allowed to take a bath, to shower, walk
around, etc and push in the position she wants to.
We have a c-section rate of 8%. Breech babies do not routineously result in
a ceasarian. These ougth to find place in the hospital, bc stage 3 of the
delivery have to be faster.
There is no such thing as a VBAC (as a 'political' phrase). Women who had a
c-section aren't routineously adviced agaist a vaginal birth. It depends on
the reason for the c-section.
We have one of the lowest perinatal mortality rate of the world, together
with the Scandinavian countries. This is due to the birthing system , but
also due to good screening during pregnancy and good postnatal care. Every
woman who wants to gets a maternity nurse over her house for 7 to 10 days
after the delivery. This is true for home births and hospital births as
well. This maternity nurse controls mother and baby, and runs the household
during 8 hours a day. The midwife also attends the women every day, till 7
days after delivery.
Midwifes are very good educated and trained. Much better than in surrouding
countries, where midwifes often are kind of supporter of the gyn. These
midwifes aren't allowed to work in our country, unless they've run extra
classes.
Now, if only the bf situation was that good, I would be very happy!!!
Unfortunately bf isn't seen as important. almost half of the people who
start with breastfedeing, stop nursing during the first week. Probably on
advice of the midwifes who think the women needs her rest, and bc of the
bad advice the maternity nurses give. :(
Annelies Bon
Breastfeeding Resources http://utopia.knoware.nl/users/abon/bfbronnen.html
breastfeeding counsellor of the Dutch bf org "Borstvoeding Natuurlijk"
mailto:[log in to unmask]
living in a small city, Almere, near Amsterdam, The Netherlands
ps, my sons were born at home. My oldest boy was suctioned, and the midwife
said jokingly; 'look, he tries to suck on it". I had much trouble with
latching on but this was also due to other things. He probably had a severe
headache. His back head was twice as long as it became later. He looked
like he was delivered by vacuum. He was 4490 gram and his head was (and
still is) above the p99 on the growth charts. He also got lots and lots and
lots of sugar water what made him nausuated.
=========================================================================
Date: Sat, 2 Jan 1999 13:55:20 PST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: laurie wheeler <[log in to unmask]>
Subject: mediawatch - reply from clinique (re bottle/formula tie in)
Mime-Version: 1.0
Content-Type: text/plain
>From: tech <[log in to unmask]>
>To: "'LAURIE WHEELER'" <[log in to unmask]>
>Subject: RE: Other question (Site Feedback)
>Date: Mon, 28 Dec 1998 17:09:20 -0500
>
>Many thanks for your e-mail. We're sorry that you did not care for our
>advertisement. We have forwarded your comments and inquiries to the
>appropriate executives at Clinique. We value our consumers and their
>opinions and hope you will >continue to look to Clinique with
confidence and satisfaction for all your >skin care and makeup needs.
>
>Thank you.
>Clinique Tech
>
>
>-----Original Message-----
>From: LAURIE WHEELER [SMTP:[log in to unmask]]
>Sent: Saturday, December 26, 1998 9:53 PM
>To: [log in to unmask]
>
>I am writing about the Dec 98 issue of Allure Magazine, where I was
>>disappointed in your ad for Clinique Turnaround Cream on p. 17. The
baby >bottle tie-in was clever, but does not equate health and youth to
me. The >feeding bottle as a symbol for babies is very pervasive in the
media.
>
>However, numerous health organizations, struggling to promote the much
>healthier choice of breastfeeding, would like to see that changed. In
a >recent policy statement (Dec 97), The American Academy of Pediatrics
>states that practitioners should "encourage the media to portray
>breastfeeding as positive and the norm."
>>
>You may think that I am being very picky about this. However, whenever
>women see this type of symbolism, they become more convinced that
bottle >feeding is healthy for babies, which is very far from the truth.
You may >not know all the health problems assoc. with bottle feeding,
but I urge >you to change your ad.
>>
>Sincerely,
>
>Laurie Wheeler, RN, MN, IBCLC
>Louisiana Breastfeeding MediaWatch Campaign
>Violet LA 70092
>[log in to unmask]
>
>Note: The Louisiana Breastfeeding MediaWatch Campaign is part of the
>National Breastfeeding MediaWatch Campaign, sponsored by the Texas Dept
of Health, an ongoing project of the Bureau of Clinical and Nutrition
>Services. For more information, call (512) 406-0744.
______________________________________________________
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=========================================================================
Date: Sat, 2 Jan 1999 17:08:39 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Judith K. Campbell, RN, BS, IBCLC" <[log in to unmask]>
Subject: Problem and Question
Mime-Version: 1.0
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Happy New Year fellow lactnetters! I'm looking forward to a year of more
breastfeeding families and continuing to learn from all of you. I've been
mostly a "lurker" on Lactnet since Sept.'98 but feel like I have many new
friends and collegues. Enough of the chatter, now down to business. I have a
problem which the Mom in my support group has given permission for me to
share with you. Seven month old has been solely BF except for receiving
several bottles of EBM while visiting family at 3 mo. of age. No more bottles
until family went out of town over Thanksgiving and left baby for several
days with G'mother along with bottles of EBM. Baby takes cereal and I
believe some vegs. and fruit, but will not drink anything, EBM, juice from
bottle or cup. I know , SMART BABY! but.... Mom and Dad want to leave baby
with G'Mom in Feb. for 5 days while they go to a combined conference/holiday.
I have used the references I have, Dr. Ruth Lawrences book, Breastfeeding and
Human Lactation, LLL Answer book and gone over all those suggestions with Mom
and even offered to come to her home wo see if I can get him interested in the
cup if not the bottle. I feel really stupid about this , but will it really
harm the baby if he won't take liquids for 5 days? The humorous part of this
tale is that Mom planned to Brstfeed for just 6 months. That breastmilk
really IS powerful stuff isn't it!??!! Now for the question. I was trying to
rapidly ( don't think that's possible, tho) go through the posts that I'm
behind on and in my haste deletead something I should have saved. There was
a post around mid-December about suggestions for bfdg. positions for large
breasted women. I think someone gave an internet address. If the person
posting that could e-mail me privately I would appreciate it. I'm sorry for
such a long post. TIA from LaGrange, Georgia, USA ( where it's 40 deg. and
raining, but occasionally miss the Illinois snow that you' all are probably
getting right now)
. Judy, a transplanted southerner by choice and luvin' it!
=========================================================================
Date: Sat, 2 Jan 1999 17:15:02 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Cathy Bargar <[log in to unmask]>
Subject: professional respect
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As the originator of this current discussion about routine suctioning, "blue
bulb" aspiration,etc (which is getting a little hot, if you ask me!), I feel
like I have to jump in here again. I gotta say, Andrew, that your recent
string of posts on this matter seems to be striking a kind of condescending
note, starting with the "psychobabble" comment (was that you? If not, please
accept my apologies) and continuing through recent allusions to graveyards
full of dead babies.
My understanding is that this list is for fellow professionals concerned
with the well-being of babies and moms; I'm willing to bet that there isn't
a one of us out here who would endorse anything less than the absolute
"best" (i.e. high-tech) medical care available to modern medicine, in those
cases where it's necessary to save life and health of the babies we care
for. Are those of us expressing concern about some of the unneccessarily
intrusive procedures we've seen, and describing the sequelae that we've
noted in our professional work, saying that babies should be left to die in
their aspirated mec rather than be traumatized by necessary suction? I don't
think so!! Give us a break here! You know, I know, we all know that there
can be a wide spectrum of how, when, and by whom any of these potentially
intrusive/traumatic procedures can be carried out, that there are "good
ways" and "bad ways" to use any technology or intervention. We all are
well-served by hearing about others' experiences. I know that I'm not saying
"you should never suction a baby", and I don't think you're saying
"suctioning couldn't possibly cause breastfeeding problems" - at least, I
sure hope that's not what you're saying, because there are a whole lot of us
here telling you that we have seen it cause major problems and worked hard
to help overcome those problems (not always successfully, I have to admit).
Yup, a live formula-feeding baby is better than a dead would-be breastfed
one any day! No argument!
I learn a huge amount form the experience and knowledge of others on this
list; when one of you who has more knowledge than I do about a subject
speaks, I listen and learn. I wouldn't learn very much if I just dismissed
the professional experience of my colleagues; this is especially true of
those with different experience, training, backgrounds than my own. When a
ped describes her experience in a NICU or ER, or a doula talks about women
she works with after birth at home, or a LLLL shares from her 20+ years of
seeing all kinds of moms and babies, and when she shares her observations
and conclusions with us, it's of value to me. I might disagree with a
conclusion, or my experience with something may even be contradictory to
something described here, but it sure gives me a lot to think about.
Hopefully, my patients will benefit too! But I find it kind of off-putting
when "one of our own" dismisses someone's thoughful comment about oral
trauma as a form of rape as "psychobabble", and goes on to fling up the
spectre of cemeteries full of the dead babies of years gone by as a response
to a lively and informative discussion. Not intending to flame anyone here,
honest!
Just my (NSH) opinion!
Cathy Bargar
=========================================================================
Date: Sat, 2 Jan 1999 17:42:18 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Cathy Bargar <[log in to unmask]>
Subject: rubber stamps and Furbies
MIME-Version: 1.0
Content-Type: text/plain; charset="iso-8859-1"
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Look how it all ties together here! Someone commented a few days back about
how obnoxious those Furby things are, and someone else was talking about
having their toddlers request Mommy to nurse all the little toys & stuffed
animals (yes, indeed it's a high compliment to the Power of Mother!). My
step-daughter got a Furby for Christmas (for those of you who may not know,
these are little stuffed animal-type things that talk in their own language
and demand to be petted), and I have to say that it has a beak-like little
mouth that certainly wouldn't make anyone inclined to nurse it! I'd run the
other way, protectively shielding my nipples!
It seems so peculiar to me that a kid would want a toy that speaks in a
"real" voice - it even comes with a little dictionary so you can translate
what it says!. Seems to me that the whole point of the various stuffed
creatures you have when you're a kid is that YOU can make them say or be or
do anything you want them to. All my dolls had distinct personalities and
voices and preferences, but part of what made them so wonderful to me was
that they were all in my imagination. I would have found it really offensive
to have one of them start making noises on its own, or only able to say what
it had been programmed to say! My own kids (older than my step-kids) never
had these kind of noisy independent toys either, and find the Furby thingies
really repulsive.
Does this mean that I'm old now?
Cathy Bargar - who may sound like a curmudgeon sometimes, but will freely
admit that it's easier to buy Christmas presents for little kids than for
young adults!
=========================================================================
Date: Sat, 2 Jan 1999 18:18:38 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Betsy Riedel, R.N.C." <[log in to unmask]>
Subject: Re: LACTNET Digest - 2 Jan 1999 - Special issue
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In a message dated 1/2/99 3:20:42 PM US Eastern Standard Time,
[log in to unmask] writes:
<< When was the last time you
saw a natural birth? There are VERY FEW in hospitals, if any -- >>
The small community hospital where I work does quite a lot of natural births.
If some of you can get out of those big centers with all those
interns,residents, and NICU's, you'd see that it is, indeed, possible to have
a baby with little or no intervention (except maybe for some external
monitoring). It's also possible to have a baby without a septic work-up, even
if mom has had an epidural and an elevated temp along with it.
My point is that there are hospitals, docs, and midwives with the low-
intervention approach. They are probably among the minority, but I think the
numbers are growing as more practitioners see the good in minimal intervention
and more parents demand this type of approach.
Betsy, R.N.C. in Connecticut (where it is in the teens with a high wind).
=========================================================================
Date: Sat, 2 Jan 1999 17:31:15 -0600
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Kathy Dettwyler <[log in to unmask]>
Subject: cord clamping, again
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Gail Hertz writes:
>1. Delayed clamping of the cord causes a higher volume of blood to enter
>the baby - the problem is greater, the smaller the baby. [The plasma
>(liquid) part of the blood can pass through the vessel walls but the red
>cells stay in the vessels.]
>
>2. "Stripping the cord" - that is squeezing the cord blood into the baby
>has the same effect as 1.
>
>3. holding the baby below the mom at delivery - same effect as 1 again.
Thanks for the education, Gail, and others. I've learned a lot! I think it
is interesting that reasons 2 and 3, above, are both cultural practices --
obviously not what happens naturally during human childbirth. But I'm
curious about what happens when you just leavecord alone. This is surely
what happened throughout most of human prehistory and history, and is still
what happens throughout most of the world today -- and yet the vast majority
of babies don't have any apparent problems from this. How long is
"delayed"? Neither God nor evolution (however you think humans got to their
modern form) planned for someone to cut the umbilical cord within a specific
length of time after the birth.
Kathy Dettwyler, Ph.D.
Associate Professor of Anthropology and Nutrition
Texas A&M University
College Station, TX 77845
co-editor of "Breastfeeding: Biocultural Perspectives"
http://www.prairienet.org/laleche/dettwyler.html
=========================================================================
Date: Sat, 2 Jan 1999 18:45:27 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Tracy Kirschner, La Leche League Leader & Doctor of"
<[log in to unmask]>
Subject: Adopted Baby
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Can anyone give me the name of the most acceptable formula to feed a 5 week
old adopted baby? She's been getting goat's milk and the parents feel it's not
enough. Is there a supplement that can be put in the goats milk to up it's
nutritional value for the baby? That would be ideal as they are getting very
fresh, pure organic goat's milk.
Thanks,
Tracy Kirschner, DC
=========================================================================
Date: Sat, 2 Jan 1999 19:02:14 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Cindy Curtis <[log in to unmask]>
Organization: Benefits of Breastfeeding
Subject: Re: Adopted Baby
MIME-Version: 1.0
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Human milk from a milk bank? ;-)
Cin
--
Cindy Curtis,RN,IBCLC
Virginia,USA
mailto:[log in to unmask]
Benefits of Breastfeeding Page http://www.erols.com/cindyrn
=========================================================================
Date: Sat, 2 Jan 1999 19:11:11 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: JACK A RUPP <[log in to unmask]>
Subject: THRUSH (LONG)
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In response to Patricia Bucknell's request for more suggestions about an
intraductal yeast infection, I have several. A ductal (systemic) yeast
infection will take a great deal of time and discipline to resolve. However
even if the mother switches to formula, she will still have to deal with the
systemic infection which may manifest itself in other ways throughout her
system - yeast is extremely pervasive! Diflucan IS the antifungal that will
be most effective, however most pharmacists and "yeast experts" would
suggest a longer course. In MEDICATIONS AND MOTHERS' MILK, Thomas Hale,
Ph.D, (pg.267) suggests a 400mg. loading dose followed by a daily dose of
200mg. for a minimum of 28 days. If a relapse occurs, he suggests the
200mg. dose for up to 12 weeks. (He gives very positive safety remarks on
this drug's use in nursing mothers.) This is consistent with the opinions
of other health professionals who are knowledgeable about treating systemic
yeast. A lower dosage may actually set the mother up for a
diflucan-resistant strain of yeast. Her acidophilus/garlic treatments sound
great, but she may have to tighten up her diet even more. Many women with
systemic yeast are sensitive also to yeast-containing foods and foods with
any type of fungus or mold - the obvious ones being bread, vinegar and other
condiments, mushrooms, and fruit juices. Often sugars and yeast are hidden
in foods the mother may be eating disguised under other names. Check labels
carefully! She may even need to remove any simple or enriched carbohydrates
from her diet for a few weeks to resolve this, as they are converted into
sugar in her system. While not much research has been done on ductal yeast,
it would seem that this is the hardest type of yeast to kill because despite
the mother's diet, the yeast is thriving on the sugars in her milk. So a
very strict diet and supplement schedule is in order in addition to the
diflucan. I highly recommend THE YEAST CONNECTION by William Crook, M.D.
While he doesn't specifically address yeast in breastfeeding women, a better
understanding of the pervasiveness of this fungus and the treatment options
will be very enlightening to the mother.
Good luck - this was the story of my life for six months and I overcame it
and am still nursing!
Libby Rupp, LLL leader from Ellicott City, MD
(anxiously awaiting a huge ice storm!)
=========================================================================
Date: Sat, 2 Jan 1999 20:05:36 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Linda L. Shaw MD" <[log in to unmask]>
Subject: Re: Adopted Baby
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Tracy:
Adopted infants whose adoptive moms can't lactate or who can't receive donor
human milk should get one of the commercially available formulas. I would
vote for using one of the standard cow-milk based formulas such as Enfamil or
Similac, as there are some significant concerns with soy-based products and
the elemental formulas are very, very expensive and not necessary for most
babies. Goat milk is deficient in several important nutrients and even less
like "mom's own" than the commercial formulas--whole goat milk is no more
appropriate for human infants than is whole cow milk. At least the formulas
are actually based on current understanding of infant nutritional needs, and
babies will generally do OK with them.
Linda L. Shaw MD FAAP
=========================================================================
Date: Sat, 2 Jan 1999 20:11:42 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "ROBERT CORDES D.O." <[log in to unmask]>
Subject: clarithromycin taste
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I recently had a mom call me b/c she was put on clarithromycin (Biaxin in
the USA). Her doc said it was OK while breastfeeding and
I agreed. Her doc also told her it might change the taste of her milk such
that the baby wouldn't
like it.
I took clarithromycin once and had that 24 hour a day metallic after taste.
A known side effect. Bad enough that I stopped the med. Hey
it was for otitis which is usually self limiting in children so I figured it
would be more so
for adults.
Anyway does anyone have info on the transfer of clarithromycin into milk? Is
it enough to cause the
after taste?
-Rob
Rob Cordes, DO, FAAP, FACOP
Wilkes Barre, PA
mailto: [log in to unmask]
=========================================================================
Date: Sat, 2 Jan 1999 00:45:33 -0600
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: tjms_eliz <[log in to unmask]>
Subject: Little Green Breastfeeding Book
Hello Lactnuts:
If someone knows the e-mail address to get Gail Hertz book, I would
appreciate it if I could have the address to ask for the book.
Thanks to all of you for the information I have obtained in the past year
98'.
Paula [log in to unmask]
=========================================================================
Date: Sat, 2 Jan 1999 21:00:41 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Patrica Young <[log in to unmask]>
Subject: Re: clarithromycin taste
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Dear Rob, I would imagine it would flavor the milk.T. Hale says "it is a
weak base and would concentrate in human milk by ion trapping, but it IS
prescribed for babies over age 6 mo." Personally I hardly ever use it for
kids because of the taste, kids can't keep it down long enough for it to
work! I've taken it personally and the taste is persistent throughout the
whole course of it's use. Sincerely, Pat in SNJ
=========================================================================
Date: Sat, 2 Jan 1999 21:07:59 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Patrica Young <[log in to unmask]>
Subject: Re: umbilical cord answer
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>
> Babies with polycythemia often look "ruddy" and dark pink in color.
Hi Gail, you forgot to mention that this color is before they turn orange
from increased bili caused by having to get rid of more RBCs. Sincerely,
Pat in SNJ
=========================================================================
Date: Sat, 2 Jan 1999 21:42:05 -0800
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Steve Salop and Judith Gelman <[log in to unmask]>
Subject: what to feed the adopted baby when there isn't human milk
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Everyone on this list is devoted to human milk for human milks and we
all know what is wrong with formula. Nevertheless, we need to recognize
that commercial ABM is far more suitable than goat's milk or soy milk or
any other substitute, no matter how organic, when an infant cannot have
access to human milk.
I work with many adopting mothers. Sometimes I wonder how these women
have so thoroughly picked up the message that commercial ABM is
problematic when some many people in our culture haven't got a clue.
Some of the ideas I have heard about what to feed the baby instead of a
commercial ABM are really scary! I always tell mothers that until the
time that they have a full milk supply or their child is one year old,
commercial ABM is the only acceptable alternative.
The soy milk or goat's milk or rice milk or almond milk may be organic
but it is totally unsuited for human brain growth. As professionals, it
is absolutely essential that we help women make informed choices and
that we help them understand what is at stake if a baby is feed
something as inappropriate as some of these "alternative" substitute
"milks".
Happy new year to you all!
Judy Gelman, IBCLC
Washington, DC, where the ground has a slick new cover of ice.
=========================================================================
Date: Sat, 2 Jan 1999 22:01:43 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Carol Brussel <[log in to unmask]>
Subject: goats' milk formula
Comments: To: [log in to unmask]
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dear tracy and all,
i decided to post this and not just respond privately, because it is a topic
that has come up before and warrants a reminder to those who have not seen the
previous posts, to please go to the archives and see them all. although there
is strong feeling among some people that goats milk is more similar to human
milk than cow's milk, this is just not true. also, there is no justification
for using home-made formula, as it makes commercial varieties look just
terrific in comparison. also, not twenty-five miles down the road from your
location, tracy, is a milk bank bursting with human (you know, species-
specific) milk. you would be doing these parents a favor by recommending
either a commercial formula, or donor milk. they can talk to the milk bank
about their situation, and the women there can help these parents decide if it
is the best route to take.
also, i don't believe it is in the purview of anyone in la leche league or
serious lactation work to advocate using a home-made formula. there are
liability issues as well as ethics issues involved here. although i do know
that in your area, there are some strong beliefs about this, we need to work
towards a science-based practice (thanks, barbara) or an evidence-based
practice, both of which attitudes would preclude using goat's milk.
yeah, i know, jay, but it is the "babies survive anyway" story sometimes.
carol brussel IBCLC
=========================================================================
Date: Sat, 2 Jan 1999 22:06:47 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Margery Wilson <[log in to unmask]>
Subject: Re: birth interventions and mortality rates (real vs. constructed
history)
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"Andrew MD" wrote:
< Well, go visit an "old" cemetery and count the infant graves
and then go to a "new" cemetery and count the infant graves.
...Perhaps we should go back to the prehistoric "good ole
days" when more than 50% of infants did not make it to one
year of age. To paraphrase a famous quote: Those who do
not know their history are doomed
to repeat it.>
As someone who does spend lots of time in old churchyards
(in the UK and USA) and in researching birth statistics from
the fourteenth to eighteenth centuries, I would like to ask
where your references are regarding the 50% infant mortality
rates? I think you are a victim of unfortunate chauvinist
constructs that make us think "we" "now" are "civilized" and
somehow better off in all ways. In prior centuries women had
higher mortality rates during childbirth (nowhere near 50%!)
than today, but babies fared pretty well as long as their
mothers survived. In fact, until "modern" medicine came
along neonatal mortality rates (for birth) were comparable to
today's rates. After medical doctors appeared there was a
sudden rise in neonatal demise during childbirth!
Obstetrics, as a science, has a very interesting history. If
you go back to the beginnings you will find that the
population physicians had available for "practice" were
primarily high risk patients -- what we would today call street
people and/or "financially challenged". These women were
often unhealthy, and lived under the most trying
circumstances. The women "of means" wanted nothing to do
with doctors. (This changed as physician attended birth
became trendy...then rich women started having riskier
childbirths.) Thus, from the very genesis of the speciality,
obstetrics practice has been based on the premise that every
pregnancy is high risk until proven otherwise.
Those of us who battle against breastfeeding myths that have
been passed from textbook to textbook from the last century
know how difficult it is to extinguish practice once it is
immortalized in a medical text!
The statistics (there are many references available) are
sobering. Childbirth became more risky as "modern
medicine" took over! Of course, even today, and when faced
with statistics showing MD assisted births are no safer than
midwife assisted births (yes, even when corrected for risk
factors) many physicians suffer HITSS (head in the sand
syndrome).
This post is not intended as a rant against obstetricians,
pediatricians or any other health care provider. (Really!) Of
course -- no one can deny that today we can save babies
who are at high risk who would not have made it in prior
centuries. At the same time, its a pity we are blinded to the
fact that medicalization of childbirth has also created risk.
To paraphrase your quote: Those who do not know their
history are doomed to misinterpret it.
Margery Wilson, IBCLC
Massachusetts Institute of Technology
Medical Department
Cambridge, Massachusetts, USA
=========================================================================
Date: Sat, 2 Jan 1999 21:49:06 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Patrica Young <[log in to unmask]>
Subject: old practices
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Gee Linda, you forgot the leeches, actually that is being reevaluated and
used now days! But appropriately for certain conditions, not willy nilly
on everyone. Sincerely, Pat in SNJ
=========================================================================
Date: Sat, 2 Jan 1999 21:56:32 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Patrica Young <[log in to unmask]>
Subject: Re: bulb syringe
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At the risk of grossing you all out - moms sucked mucus out or blew into
baby's nasal passages to clear them out - still done in some cultures as
everyone doesn't have the ubiquitous blue bulb syringe. Sincerely, Pat in
SNJ
> If it were essential to use a bulb syringe, how on earth did we ever
survive
> 1000's of years of birth & bf before Goodyear (or whomever) developed
rubber?
=========================================================================
Date: Sat, 2 Jan 1999 22:05:20 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Patrica Young <[log in to unmask]>
Subject: Re: containers for expressed milk
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Chris, canning jars in pints and 1/2 pints can also be frequently found at
yard sales. I've seen even smaller ones used for jelly. New lids and rings
are available in supermarkets. Sincerely, Pat in SNJ
=========================================================================
Date: Sat, 2 Jan 1999 22:13:10 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Patrica Young <[log in to unmask]>
Subject: fluids for baby
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I would simply add more fluids to cereal, fruits and veggies. Baby gets
fluids, grandma doesn't get grief trying to coax baby to take cup or
bottle, Also baby will be several mo older and might be more willing to
try a cup or spoon for liquids. Sincerely, Pat in SNJ
=========================================================================
Date: Sat, 2 Jan 1999 22:20:49 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Patrica Young <[log in to unmask]>
Subject: Re: Adopted Baby
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After banked human milk, there are more appropriate formulas for an adopted
baby
than fresh goats milk. A concocted formula that we frequently denigrate is
preferable to an untreated animal milk. Goats milk is lacking some
important things. Hope an RD will chime in here. Sincerely, Pat in SNJ
=========================================================================
Date: Fri, 1 Jan 1999 11:02:25 +1030
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Ellen McIntyre <[log in to unmask]>
Subject: Re: Quadruplets---reference
Comments: To: "Debi Page Ferrarello, RN, IBCLC" <[log in to unmask]>
MIME-Version: 1.0
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Hi Debi
Found the references:
Mead L et al Breastfeeding success with preterm quadruplets JOGNN 1992
May/June p221-227
Storr G Breastfeeding Premature Triplets JHL 1989 5(2) p74-77
Best of luck to the mother
Ellen McIntyre, South Australia
=========================================================================
Date: Sat, 2 Jan 1999 22:27:11 -0600
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "[log in to unmask]" <[log in to unmask]>
Subject: Re: birth interventions and mortality rates (real vs. constructed
history)
In-Reply-To: <[log in to unmask]>
Mime-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
Margery, thank you for a fine post, with astute perspective.
This post is certainly going into my Best of Lactnet file.
Patricia Gima, IBCLC
Milwaukee, Wisconsin, USA
mailto:[log in to unmask]
=========================================================================
Date: Sat, 2 Jan 1999 23:46:29 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: T Pitman <[log in to unmask]>
Subject: the trauma of birth
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I think that birth can be traumatic for a baby, but I certainly don't think
it always is. I have wonderful photos of my daughter's birth - taken 20
years ago - and she is wide-eyed, alert, calm and looking around the room
within a minute or so of being born, then settled in to nurse for more than
30 minutes. I remember my second son, newly born, nursing for a few minutes,
then letting go and looking up at me and smiling. I know, I know, they'll
say it was gas, but I saw that smile - and it was a look of peaceful,
relaxed happiness.
Not that all births are without incident, or this peaceful, but certainly to
think of birth as universally traumatic to the baby goes against not only my
own experiences, but what I've seen at some of the births where I have been
a doula.
Teresa Pitman
LLL Leader, Oakville, Ontario
=========================================================================
Date: Sun, 3 Jan 1999 00:13:52 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Patrician Drazin IBCLC <[log in to unmask]>
Subject: Re: blue bulb syringe
Mime-Version: 1.0
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Interestingly, I noticed one advertized in a baby catalog that arrived
today { desepite many many inches of snow}... "hospital quality appliances
make baby care eaiser".. "the easy clean aspirator clears baby's breathing
passages, using gentle suction action"
Patricia
{ chicago where it is truely a winter wonderland!}
=========================================================================
Date: Sun, 3 Jan 1999 00:13:54 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Patrician Drazin IBCLC <[log in to unmask]>
Subject: Re: Furbies
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Cathy:
we are quickly getting off of breastfeeding BUT childrens toys and
entertainment was been taken over by technology - much the same way that
breastfeeding has been! instead of encourageing children to use their
imagination there are toys and video games and television to imagine for
them... all they have to do is sit... like sitting in a carrier with a
mechanical hand holding the bottle so mom doesn't have to!
Patricia
=========================================================================
Date: Sun, 3 Jan 1999 00:18:56 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Ruth Scuderi LLLL <[log in to unmask]>
Subject: Re: Formula Recommendation for Adopted Baby
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I would like to point out that as La Leche League Leaders it is considered out
of our realm of expertise to recommend which breast milk substitutes of any
kind be given to a baby. We are instructed to refer the mother back to her
doctor if she is going to stop breastfeeding. The mother needs to ask the
doctor about bottle-feeding a baby and what to put into the bottle.
Ruth Scuderi
Westfield, MA
=========================================================================
Date: Sun, 3 Jan 1999 01:03:31 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Kathleen Bruce <[log in to unmask]>
Subject: goat's milk
Mime-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
Look up Goat's milk in the archives. Goat's milk is an inappropriate food
for babies, due to high solute load.
See archives.
Kathleen
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet,TLC, Indep. Consultant
Williston, Vermont, where temperatures are in the single digits....
mailto:[log in to unmask]
LACTNET Archives http://library.ummed.edu/lsv/archives/lactnet.html
=========================================================================
Date: Sun, 3 Jan 1999 01:03:32 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Kathleen Bruce <[log in to unmask]>
Subject: respect
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Just a reminder. The rules of the list state that all posts must be made in
a respectful tone. This is a rule that is necessary. Please keep this in
mind when posting, and if you have something to say that isn't for the cover
of the New York Times, please send it via private email, or maybe not at all.
Thank you. Let's keep it professional and respectful, as it usually is.
This is a forum for learning...and we intend to keep it just that.
Kathleen, where the big storm is about to hit.
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet,TLC, Indep. Consultant
Williston, Vermont, where temperatures are in the single digits....
mailto:[log in to unmask]
LACTNET Archives http://library.ummed.edu/lsv/archives/lactnet.html
=========================================================================
Date: Sun, 3 Jan 1999 07:46:31 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Patrica Young <[log in to unmask]>
Subject: Re: birth interventions and mortality rates (real vs.
constructedhistory)
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Dear Pat, that sounds like a neat folder. Some really nice Lactnut visited
and taught me how to make files. I'm in 7th heaven now that I can. I have
addresses and articles (bib stuff) so far. Now I'll have "Best of Lactnet"
too. Sincerely, Pat in SNJ who is slowly figuring out the computer.
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Date: Sun, 3 Jan 1999 08:03:08 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Patrica Young <[log in to unmask]>
Subject: Re: the trauma of birth
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The sad thing tho is that most births could be peaceful.............without
so much intervention! Sincerely, Pat in SNJ
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Date: Sun, 3 Jan 1999 09:16:28 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Carolyn A. Strom" <[log in to unmask]>
Subject: Re: LACTNET Digest - 31 Dec 1998
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UNSUBSCIBE LACNET
[log in to unmask]
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Date: Sun, 3 Jan 1999 10:05:52 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Sarah Barnett <[log in to unmask]>
Subject: Re: Birth interventions and cord (long)
Comments: To: Gloria Buoncristiano-Thai <[log in to unmask]>
In-Reply-To: <[log in to unmask]>
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Gloria
At the 1997 LLLI conference in Washington DC, Dr. Alfredo Pisacane did
say that the cord should not be cut until after it stops pulsating to
prevent anemia. My notes say that 1-4 minutes of pulsating cord before
cutting while the baby is *on breast* increases iron stores so that baby
needs no early fortification. Unfortunately I do not have any note about
what happens if the baby is elswhere (i.e. abdomen) nor did I write down
why the "on breast" is particularly important. (I did underline it twice
though).
Sarah
Sarah Friend Barnett LLLL, IBCLC
Bronx (New York City), NY - [log in to unmask]
" You are not obliged to finish the task,
neither are you free to neglect it." R. Tarfon
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Date: Sun, 3 Jan 1999 10:12:51 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Linda J. Smith" <[log in to unmask]>
Subject: birth trauma depends on the birth
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Coach Smith here again. Sorry, I can't let this idea of birth trauma rest
either.
Whether and to what degree birth is traumatic for the baby depends on how
the labor is (or isn't) managed, how the baby is welcomed into the outside
world (gently or forcefully, with kindness or with cruelty) and many other
factors, only some of which are reaching our collective research journals.
Dr Frederick LeBoyer started the recent investigation into what birth is
like for the baby by looking at the baby's face shortly after birth. At the
time Birth Without Violence was published (early 1970's) babies were usually
held upside down by the ankles and smacked on the buttocks to "help them
breathe." The "LeBoyer bath" was an attempt to ease the transition from
inside to outside for the baby, along with lowered lights, quieter
environment, and gentle handling. The "bath" part never really caught on.
However, overall handling of newborns became much more gentle and sensitive
because of the widespread acceptance of the concept that babies are very
aware at birth, with most of their senses fully functioning.
Actually Ashley Montagu looked at these issues even longer ago. His 3rd
edition of "Touching - the human significance of the skin" is even better
than the first edition, and IMHO should be required reading for all health
care providers. Dr. Montagu is still alive and well (but in his words,
suffers from a terminal condition called old age) and lives in Princeton NJ.
Dr. Michel Odent carries on similar research and thinking at the Primal
Health Institute in London. He publishes a newsletter and the web site is
http://www.primal-health.org. Another group seriously investigating this is
the association for pre and perinatal health - the website for entering this
theme is http://birthpsychology.com Fascinating stuff there. I've posted
my growing bibliography on "Roots of Violence" on Lactnet and will be adding
to it as more research emerges. Read "Ghosts from the Nursery" if you have
any lingering doubts about the connections between early insults and long
term sequelae.
It took the development of electronic fetal monitors before the health care
establishment acknowledged what narcotics given during labor to the baby.
Now we in the lactation field are looking closely at the baby's ability to
breastfeed, and asking "WHY can't this otherwise normal, healthy newborn
feed normally?" Simply asking that question is provoking a huge
re-assessment of ALL "routine" birth practices. And for good reason, IMO.
Just because some babies manage to survive and thrive despite being smacked,
snogged, drugged, etc does not justify the idea that these are innocuous
practices to be inflicted on all unsuspecting and undeserving babies. ONE
MORE TIME: interventions should be used carefully, judiciously, and only
when truly necessary. The "routine" intervention of today could quite easily
be relegated to the "horror file" of tomorrow.
Linda J. Smith, BSE, FACCE, IBCLC
Bright Future Lactation Resource Centre
Dayton, OH USA where we were snowed in all day yesterday, the roads are
still a mess today, and it's still snowing.
http://www.bflrc.com
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Date: Sun, 3 Jan 1999 10:13:55 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Richard C Lussky <[log in to unmask]>
Subject: Re: pacifiers - ? history
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On Sat, 2 Jan 1999 12:28:15 PST wrote...
>Linda,
>I was just wondering about pacifiers, as a result of a cousin bf and
>using them. Did you find out about the history of them? Who started it?
>Who invented it and why? and where?
>laurie
>
>Laurie Wheeler, RN, MN, IBCLC
>Hosp LC
>Violet Louisiana, USA - rainy SE USA
>mailto:[log in to unmask]
>
>
>______________________________________________________
>Get Your Private, Free Email at http://www.hotmail.com
>
>
Dear Participants of Lactnet,
If anyone has answers to these questions - I think we would all be
interested.
Thanks,
Rich Lussky M.D.
Richard C. Lussky M.D.
Assistant Medical Director of the Newborn ICU
Department of Pediatrics - 867B
Hennepin County Medical Center
701 Park Avenue South
Minneapolis, MN 55415
Phone: (612) 347-2960
Fax: (612) 904-4284
E-mail: [log in to unmask]
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Date: Sun, 3 Jan 1999 10:17:18 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Richard C Lussky <[log in to unmask]>
Subject: Re: Little Green Breastfeeding Book
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On Sat, 2 Jan 1999 00:45:33 -0600 wrote...
>Hello Lactnuts:
>If someone knows the e-mail address to get Gail Hertz book, I would
>appreciate it if I could have the address to ask for the book.
>Thanks to all of you for the information I have obtained in the past year
>98'.
>Paula [log in to unmask]
>
>
Hi folks,
I would also be interested in this address/phone number.
Thanks,
Rich Lussky M.D.
Richard C. Lussky M.D.
Assistant Medical Director of the Newborn ICU
Department of Pediatrics - 867B
Hennepin County Medical Center
701 Park Avenue South
Minneapolis, MN 55415
Phone: (612) 347-2960
Fax: (612) 904-4284
E-mail: [log in to unmask]
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Date: Sun, 3 Jan 1999 10:19:45 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Sarah Barnett <[log in to unmask]>
Subject: Re: fluids for baby
In-Reply-To: <[log in to unmask]> (added by
[log in to unmask])
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How about home-made juice pops? They are just water. Gelatin deserts
are also basically water. The gelatin is insignificant. There is a risk
though if the baby will not take any liquids at all.
Sarah
Sarah Friend Barnett LLLL, IBCLC
Bronx (New York City), NY - [log in to unmask]
" You are not obliged to finish the task,
neither are you free to neglect it." R. Tarfon
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Date: Sun, 3 Jan 1999 10:13:02 -0600
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Forrest Peters <[log in to unmask]>
Subject: UNCOMFORTABLE PLACE TO BE.....
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To the list,
I am posting this comment after alot of thought.....I had privatly E-mailed
Andrew MD earlier with my thoughts and support (I felt he was really being
slammed) and the more I thought about it, the more I felt I must say
something to everyone else also. I had hesitated because I do enjoy
participating in discussions and I don't like to create bad feelings. I
also do not wish to be slammed or ignored by the list (esp if I need help
at a latter date ;) )
This suctioning thread has really created alot of debate and I have seen
alot of different opinions and at times some nastiness. What has really
stood out is the differences in opinion that for me at least sounds
........well......not mainstream. Please understand this is not a slam or
a criticisim & I am not saying that for these individulas and their clients
that perhaps that approach is in anyway wrong.
However you cannot expect the mainstream establishment to follow suit or
even at times view us as valid when we compare a very necessary procedure
(such as suctioning) for infants to rape. I understand that infants feel
and remember & I also believe that we need to be careful in how we approach
infants when doing necessary but potentially uncomfortable procedures. But
we turn people off... big time.... and are dismissed as kooks if we are not
careful in how we speak to not only others but to one another (especially
when the list is read by far more people than actually participate...we
need to remember that this is not a private conversation).
There are other MDs that read our posts as well as nurses who are on the
front line so to speak with these infants. We loose them when we beacome
emotional and make statements without thinking about how they may sound to
someone not as passionate about breastfeeding.
Simply saying something like..... Infants can remember trauma and may be
reluctant to BF after certain traumatic procedures. To minimize the
infants exposure to trauma, keep suctioning to a minimum depending on the
clinical situation and suction carefully when necessary, follow up with BF
support if infant is reluctant to nurse......This comes off as well thought
out and can easily be applied to a clinical situation. It also makes people
actually THINK about what they are doing ie (HMMMM...I never thought
about it that way I guess I could be more carefull when suctioning and
perhaps not all the infants I run across need suctioning)
When we make statements like "suctioning is comparable to rape"...many
health care profesionals just tune out....this means nothing to them and
how can they apply that to their practice?....and why would they want to,
because we come off sounding like fanatics?
Again, alot of thought went into this post and I am not trying to offend
ANYONE, but we need to remember that what we say is read by ALOT of people,
some of these people are in a position to help our cause if we present our
ideas as well thought out, without the emotion, in a way that is usefull to
their practice.
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Date: Sun, 3 Jan 1999 11:17:13 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Cathy Bargar <[log in to unmask]>
Subject: re;little green book
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Okay, I am ready to admit my ignorance and just outright ask: What is "The
Little Green Book"? I mean, I know it's by Gail Hertz, whose posts I read
here, but I'm not familiar with it and my usual strategy of listening &
figuring it out seems to have failed me here. Hope this request for
information doesn't brand me as hopelessly out of it...
OK to e-mail me privately if everyone else is familiar with it and you don't
want to take up space on the list. Reviews welcome, also info on how to get
it. TIA.
Look what a nerd I'm becoming with these e-mail terms! I never even laid
eyes on an e-mail message, or the internet, until mid-November, and now here
I am, spending hours with my new best friends.
Cathy Bargar
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Date: Sun, 3 Jan 1999 10:50:47 -0600
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Forrest Peters <[log in to unmask]>
Subject: uncomfortable place to be...part 2
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Dear list,
I didn't intend to close my earlier post without a by line....my computer
bumped me off and automatically sent letter prior to my last line which was...
Respectfully submitted,
Lori Peters RN (certified inpatient obstetrics), IBCLC
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Date: Sun, 3 Jan 1999 08:56:01 -0800
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Donna Hansen <[log in to unmask]>
Subject: chlorzoxazone
Comments: cc: [log in to unmask]
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Hi all,
Have a question from a mum nursing a 5 month old about taking Tylenol
extra strength for aches and pains. Active ingredients are acetaminophen
500 mg and chlorzoxazone 250 mg. The tiny drug list I have (gotta get
Tom's book!) lists acetaminophen as no problem but has no info on
chlorzoxazone. The pharmacist she called said he didn't have any info on
the muscle relaxant so guess what he said? "Since we have no studies
saying it isn't a problem you better not nurse until tomorrow" Give your
baby that other stuff that we do know can be a problem. The mum was not
too bothered by the advice to pump and dump because baby has had ABM and
bottles before but I would like to provide more correct info for future
reference. All the pharmacist would tell me was that the peak for
chlorzoxazone was 1 - 2 hours with a half life of 1 hour.
TIA
Donna Hansen
Burnaby, British Columbia
(we had the most amazing frosts for the last two nights, and beautiful
sunny days to match)
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Date: Sun, 3 Jan 1999 12:20:33 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Ann Calandro <[log in to unmask]>
Subject: A Perfect World (probably too long)
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For us in the Lactation field, the perfect world would be a place where
mothers get excellent prenatal care and learn as much as possible about
lactation before their birth.
They would have all taken classes and gone to La Leche League meetings ahead
of time. They prepare for their births, have labor support, deliver with a
knowledgable OB or midwife in a loving setting, preferably with no
medications which would cause problems for the labor or the newborn.
Breastfeeding would begin as soon as baby is ready, and babies would stay
with parents. Our jobs would be easier, babies would be happier and parents
would enjoy their success. We would be there for supporting the parents,
answering questions and helping as needed.
Realistically, that is not what I usually see, although sometimes I do. A
pediatrician once told me- Just stay in there with that baby until it
nurses. I tried to explain to her that it isn't that simple. Sometimes the
answer is tincture of time. Sometimes babies are dealing with things that
make nursing very difficult. She wondered why I couldn't just fix it and
get the baby nursing. I told her something I had read on Lactnet. I am the
one downstream, pulling the babies out of the water, trying to help them get
back to dry land. Sometimes it takes a while for them to dry out and feel
right again. Perhaps it would be helpful to look back to the place where
the babies are tossed into the water, and see what can be done about helping
them before they get tossed. Problem prevention. Things like becoming aware
of what drugs can do to newborns, what suctioning can do to newborns, what
epidurals (especially when the first one or two don't "take") can do to
newborns, what removing the baby for a bath and whisking them off to the
nursery before nursing can do to newborns. Being downstream is frustrating
sometimes, actually much of the time, because we see ways that this entire
problem could have been avoided, yet our hands are tied sometimes in helping
before the fact. We would like others to stand downstream with us and see
things from our point of view. Sometimes we get a little zealous. Perhaps
getting zealous is the way changes will be made. Being zealous in little
doses does not always turn people away. Sometimes it helps them to realize
that there is another point of view out there, and help them to think about
an accepted practice, and perhaps even question it.
Things take time. But I think about my husbands birth, when his mom was
knocked out for 24 hours when he was born, and she didn't get to hold him
for days. And was never even asked about breastfeeding. And my mother who
was given a spinal,while my dad was in the waiting room,delivered me breech
and didn't see me until I had several bottles (when she wanted to
breastfeed), and who got incorrect information from her physicians about
breastfeeding. And when we look at things that way, we see improvements
coming along. It wasn't a perfect world then.
Many of us had wonderful experiences with childbirth-unmedicated, and great
breastfeeding followed this. I was fortunate enough to experience a home
birth, and also a midwife assisted birth. Also two unmedicated hospital
births. Many of us had alert babies who knew what they were up to right
away. Or our wives have had this.
We know how fulfilling it is, and we want that for others. Many of us have
had the experience of working with wonderful breastfeeding couplets who have
been very happy and love the whole birth/breastfeeding/mothering experience.
We want that for all the mothers we work with. As LCs though we often see
the other side of breastfeeding- frustration, sleepy babies, babies who
cannot suck, babies who refuse to open their mouths, babies getting
jaundiced and/or losing weight because of the first mentioned things, and
the first mentioned things were caused by- interventions. We have to reach
into our bag of tricks and pull out things to try and help. We pull out the
pump, the SNS, the tools moms might need. All the while, cheerleading like
crazy in hopes that mom won't give up before baby dries out and feels good.
Loving everybody through the difficulties. Being positive when we don't
feel so positive. Caring a lot, sometimes maybe too much. Feeling
disappointment when things don't work out.
As Lactation Consultants, we must continue to keep the Perfect World in our
horizons for this is the goal we work towards every day. Without such
vision, we could not continue. It is our shared vision. It is why we are
here.
Ann Calandro,RNC,IBCLC
Piedmont Medical Center
Rock Hill, SC
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Date: Sun, 3 Jan 1999 12:31:23 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: NECSI <[log in to unmask]>
Subject: uncomfortable place to be
Comments: To: Forrest Peters <[log in to unmask]>
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Forrest,
Glad you said what you did. I ahve not followed the
whole thread of this conversation, just enought to know
that it was getting nasty.
We all sometimes need to be reminded that we're all on
the same side here and that our differing opinions enrich us
as a group and help us learn from one another, if we an
hear each other.
It's a bit too easy to push the send button on the
messages that should be saved till tomorrow morning
and reread.
Naomi Bar-Yam