Subject: | |
From: | |
Reply To: | |
Date: | Mon, 20 Mar 2000 17:38:12 -0800 |
Content-Type: | text/plain |
Parts/Attachments: |
|
|
Pam Morrison of Zimbabwe posted a quote from WHO/UNICEF training
materials:
"The l8 hour BFHI course (yellow manual, page 86) lists only seven
'Acceptable medical reasons for foods other than breastmilk' -
1) mother with active herpes lesion on breast/nipple
2) 3) and 4) all relate to HIV but stress that where the use of safe
alternatives to breastfeeding is not possible then breastfeeding
should continue to be the feeding method of choice,
5) mother who has severe psychosis, eclampsia or shock
6) mother who is taking cytotoxic, radioactive or anti-thyroid drugs
other than propylthiouracil and
7) mothers who specifically refuse to breastfeed."
I appreciate her making this material better known. However, it would
also be important to note the complementary list on page 80 of the
same manual, in the section on babies who need special attention.
[Please note that this manual was written in 1993; there are a few
bits of it we would reword or update in a newer edition.]
"Infants with medical conditions that do not permit exclusive
breastfeeding need to be seen and followed by a physician.
- Breastfeeding is not possible for a baby with galactosemia, because
he cannot tolerate the galactose in the breastmilk. This is a rare
condition, occurring in one out of 50,000 babies.
- Babies with other inborn errors of metabolism (e.g. PKU, MSU
disease) must be monitored for toxic serum metabolite levels for
possible adjustment in the management of breastfeeds.
- Babies with very low birth weight or who are born preterm, at less
than 1000g or 32 weeks GA may require supplementation.
- Supplementation may be necessary for babies with severe dysmaturity
with potentially severe hypoglycaemia, or who require therapy for
hypoglycaemia, and who do not imporve through increased breastfeeding
or by being given breastmilk.
- Babies with acute water loss may require water supplementation if
increased breastfeeding/breastmilk cannot provide adequate hydration."
However, lists are one thing and clinical management of the individual
baby is another, and more important. I salute the LactNet users who
are skilled at helping parents and health care providers come to a
reasoned arrangement for the care and breastfeeding of so many special
infants. Your accumulated wisdom on how to find a way around all
sorts of obstacles is an international resource!
Helen Armstrong, Consultant Infant Feeding & Care
Nutrition Section, UNICEF New York
***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
|
|