Greetings from your roving reporter--

Alicia went home today, so I'm roommateless (sniff), but spent time today
with several other netters.  We've all met a lot of people interested in
Lactnet, so you may see some new names online soon.

Today was the first full day of the big LLLI conference, with 2,057 adults
and 1,409 kids registered-- my first and I am overwhelmed.  It is practically
all multiple concurrent sessions so there is no way I can give you an
ovverview, but I'll just let you know what I did, and mention what I was
sorry to miss.

This morning's opening ceremonies featured all the founding mothers, with
keynote by one, who talked of the culture in the 40's where the male doctors
told moms it was better to bottle feed ("I'm not against the doctors, they
didn't know any better") and also commended those other doctors who told them
it was okay what they were doing, were first medical backup, and despite
being men, didn't ever try to tell them how to run LLL.
Also at this session, thanks were given to Medela for TV spot during
WorldBFWeek giving LLL 1-800 #-- will also be in other countries w/ their #s.

The first session I attended was Allan Cunningham on a global epidemiological
review of morbidity and mortality comparing BF and artifically fed infants.
 It was good, but not as deep or comprehensive as i expected, yet on another
level I liked the way he took everyone in the audience down from a stick
figure of a generic human (who can think, play music, do math, write poetry,
have a spiritual life, etc), thru the brain, down to the neuron to the
synapse, and down to the lipid membrane to the long chain fatty acids of the
various poly unsaturated fats that make up that membrane-- then showed how
those unsaturated fats, by virtue of the actual chemistry that sounds so
arcane, would make the lipid membrane more fluid and hence different than
those made with different lipids, and hence the lack of one particular fatty
acid might make a significant impact on brain development and function. then
looked at studies like Lucas and Cole on IQ etc, and another looking a
newborn vision w auditory evoked potentials, and made the whole thing simple.

Then it was nearly noon, and I went down to the exhibits, got caught in the
LLL "bookstore" which has everything in the catalog and then some, and got
caught in a huge line-- I got our own Kathleen Dettwyler's book "Dancing
Skeletons" re life and deathe in W. Africa, but the book with the chapters
she has quoted was not there.  She spoke this evening on "Beauty and the
Breast-- the cultural context of breastfeeding--" but I wasn't there because
I went to a CERP session on case studies w Ellen Shell, Chele Marmet, etc, it
was a hard call, also at that time was a dentist talking about his
investigation of prolonged on demand BF and dental caries, Miriam Labbock on
Lactational amenorrhea in child spacing, James McKenna on evolution of infant
sleep, Jack Newman on BF myths, fact/fiction, and really that many more-- and
that's just what was this evening. I may get some of them on tape.

But I skipped this afternoon-- I arrived late , from the bookstore line to
lunch in this huge, no HUGE ballroom, sat with a table of moms mostly from
Japan, awards were given to various folks including R. Lawrence and
posthumously to Niles Newton via two of her adult kids who were there, the
obgyn I mentioned yesterday and his sister; luncheon speaker was Linda Black
(pediatrician) talking on the Medicalization of BF and other Intrusions into
motherhood, talking not just about how (male) physicians took over telling
women how to do child feeding and child care this century, when these had
always been women's domain, but her talk began by reaching way way back,
reminding us of our ancient matriarchal roots, where this wasn't so, when
women's bodies, menstruation, childbirth, lactation, and menopause were all
seen as magical and spiritual and held in awe and reverence-- well, if you
remember the last major treatise I sent to this board, (before the Chicago
reports) you can imagine that this was a topic very dear to my heart, and
dear to the hearts of all those women in that huge huge ballroom.

After lunch I attended Jan Riodan's session on evaluating and using BF
assessment tools in practice-- looked most specifically at Chris Mulford's
Mother Baby assessment Score, the LATCH Bf charting system and the Infant
Brastfeeding Assessment tool(IBFAT), looking at them for reliability between
testers, etc. Session gave a good overview of process of evaluating these
tools, bottom line was that there isn't really very good inter-tester
reliability for any of them, each scoring system has it's pros and cons, but
each can be useful, at least at a charting tool, but not necessarily as a
screening tool-- validity hasn't been tested formally on any of them anyway
yet.

If you haven't followed a word I saida about these tools, let me start over--
each of these three tools is a way of evaluating a specific feeding session
for mother/baby in the initial learning phase, looking at such things as
readiness cues, latchon, audible swallowing, etc. in an "Apgar" type or
similar type scoring system We were looking at these three tools to see how
consistently different people using the same scoring system -- we watched two
videos, one of a little one who rooted around allright but never did latch
on, partly because mom's fingers kept getting in the way, and then another
video clip which was from that Chloe Fisher tape, i.e good situation, and
then we scored each of them with all three systems, and then saw how all of
us in the audience rated them.  when mom/baby feed was good, (the Fisher
tape) we were all in pretty good agreement using any of the scoring systmes,
but in the borderline situation, the scores from the audience were much more
all over the place, demonstrating not a flaw with the audience, which was a
pretty skilled group, but rather a flaw with the tests themselves-- that is,
with intertester reliability. Am I a little more clear?  However, what hasn't
been tested is validity-- ie.do these scores really mean anything? do they
rpedict who does and does not need further help and intervention? So, bottom
line, currently, any of them could be good tool for hospital charting,
 better than "well" "poor" or "5 min" but perhaps not useable at this time as
screening tool for identifying who wil/ will not get f/u.

Woah, that was a lot of time considering the dearth of space I gave some very
fascinating stuff.

Some other things I missed today, James McKenna on cosleeping and sids; Tine
Thevin on MOthering and fathering-- gender differences, but I have her book
at home and I recommend it as aonther way to look at these feminist issues--
sort of the Deborah Tannen approach to looking at parenting styles and a more
gentle way of looking at how the men took over childcare and childfeeding;
the Sears' spoke on Discipline; Ed Newton spoke on jaundice and hypoglycemia,
Barbara Heiser on role of mother support in early hosp discharge. And I
haven't even mentioned most of the regular LLL stuff.
Had dinner with a few lactnetters but it is harder to get the dozen or so of
us together in this massive crowd than a few days ago when the total
conference was about 200. This is more like trying to run into your college
roommate on campus when you go to a major state University-- the message
board is in a totally out of the way place that no one ever goes near-- With
every moment scheduled to the hilt, it is hard to find even time to get to
the exhbits, and with all the concurrent sessions, I don't know that we will
ever get together, the one momentsome of us were waiting in the lobby for
each other, Kathy Dettwyler was downstairs autographing her books in the
bookstore, and families were all trying to reconnoiter for dinner and be back
for the evening sessions--

And I was going to go to bed tonight at a decent hour.

Gn'night folks--

Tina