Dear Lactnet Members,
I wish to update you on the "Babies First" brochure. I received an
immediate response from Dr. Ginsberg, saying that he actually written the
portion of the brochure relating to breastfeeding; that he did not consider
the subject controversial; and that he did not know who had made the
decision to delete the breastfeeding portion although it did not originate
from UT Southwestern Medical School.
(That was what I was told by the Foundation)
I would therefore recommend that any comments regarding the exclusion of the
subject of breastfeeding in an educational brochure geared to parents
regarding neurological development prenatally through three years of age, be
addressed to the Foundation itself:
Coalition for Infant Development
A Project of
Dallas Foundation for Health Education and Research
President: Ralph Rogers
Vice President: Elena Barr
1341 W. Mockingbird Lane
Suite 700-W
Dallas TX 75247-6931
214-647-6786
Thank you for your help.
Jeannette Crenshaw, RN, FACCE, IBCLC
>Kathleen B. Bruce, BSN, IBCLC, LLLeader, co-owner Lactnet, LLLOL, Corgi-L
>LACTNET WWW site: http://www.mcs.com/~auerbach/lactation.html
>Personal WWW page: http://together.net/~kbruce/kbbhome.html
>
>------------------------------
>
>Date: Wed, 21 Feb 1996 09:50:03 -0500
>From: Dany Gauthier <[log in to unmask]>
>Subject: Senna
>
>For Jonathan:
>
>
>In Berkowitz RL and al. Handbook for Prescribing Medications During
>Pregnancy. Second Edition, Little Brown Pub., Senna is said to be safe in
>pregnancy, but despite their safety, attetion to proper diet and exercise is
>preferable to dependance on these agents. It says that dosage is a 2 g dose
>with results in 6 hours. As for side effects, it says that they include
>intestinal melanosis with prolonged use.
>
>In another reference "Self Medication - A guide for Haelth Professionnals"
>by the Canadian Pharm. association, it says that the effect of these agents
>(they call them contact and cathartic laxatives) relates to their ability to
>inhibit intestinal water absorption and increase permeability of the
>intestinal mucosa. It also says that they produce severe abdominal cramps,
>increase mucus secretion and in some individuals to an excessive evacuation
>of fluids.
>
>Hope this helps!
>
>
>e
>Dany Gauthier IBCLC
>[log in to unmask]
>Montreal, Canada
>Tel: 514-923-3792
>Fax:514-923-3802
>
>------------------------------
>
>Date: Wed, 21 Feb 1996 11:28:16 -0700
>From: Laura Aldag <[log in to unmask]>
>Subject: milk supply
>
>lactnetters: I have a question that will seem very elementary but I am
>struggling with understanding the mechanisms which control milk supply...how
>the supply and demand system works. I have read on here and in the Riordan
>and Auerbach text that a lactating woman's body produces more milk as a
>result of the breasts being emptied and not as a direct result of nipple
>stimulation. I understand that sucking stimulates certain nerve pathways
>which send signals to the hypothalmus and then the pituitary gland which
>causes an increase in prolactin and a resulting increase in milk production.
>So, how does the emptying of the breast fit into this other than the fact
>that they were emptied as a result of sucking and nipple stimulation. I am
>missing something. I did read that the alveoli cells collapse as milk is
>withdrawn....does this serve as some type of message to the pituitary to
>increase milk production? I want to incorporate this into a lecture i am
>giving next week so any comments/explanations would be most appreciated.
>
>-Laura
>[log in to unmask]
>Laura Aldag, M.S.,R.D.
>Assistant in Extension
>
>"Never doubt that a small group of thoughtful, committed citizens can change
>the world; indeed its the only thing that has" Margaret Mead
>
>------------------------------
>
>Date: Wed, 21 Feb 1996 13:54:46 -0500
>From: "Lisa Marasco, IBCLC" <[log in to unmask]>
>Subject: Re: Back to Sleep
>
>Andrea,
>I'm in the middle of reading Dr. Sear's new book on SIDS and just read the
>section addressing your issue. Dr. Sears suggests getting baby to sleep by
>nursing or in another position first, waiting until baby is deeply asleep
>(15-20 minutes), and then moving baby to his back. If all else fails, Dr.
>Sears does say that in some cases it might be better to "listen" to the baby
>than to force this regime upon him.
>
>However, Dr. Sears also mentions your observation that mothers who sleep with
>their babies have less problems with babies sleeping on their backs. He
>notes that babies and moms generally back or side-sleep, probably for easier
>access to each other; both seem to feel most secure this way. In the case of
>a baby alone, however, he feels that the baby may more naturally feel secure
>in a fetal position, which is best accomplished prone if not side; it is a
>case of baby "self-soothing" in absence of parents, if you will. (family bed
>is looking awfully good, isn't it?)
>
>-Lisa Marasco, LLLL, IBCLC
>[log in to unmask]@slonet.org
>
>------------------------------
>
>Date: Wed, 21 Feb 1996 13:55:13 -0500
>From: "Lisa Marasco, IBCLC" <[log in to unmask]>
>Subject: Long case
>
>Kathleen,
>
>Here is my armchair analysis, for what it's worth:
>
>If the part about the palate is true, combining that with the baby's "tight"
>mouth would indeed account for a lot of the initial pain and damage! [Had I
>seen all of this, I may have taken the baby off the breast in the very
>beginning, pumped mom, and done fingerfeeding to train the baby's suck until
>the tightness relaxed--- I had a mom I've just finished working with, and her
>baby just clamped down very tightly once you got something over the tongue,
>which loved to stay up; mouth did relax with alternate feeding, but
>unfortunately mom just gave up getting back to breast before seeing me
>again-- company interference with appts] From there, it is no surprise that
>thrush was able to set in, and of course after that came the contact
>dermatitis problem. Poor woman!
>
>A tight mouth, too much pressure with compression, whatever you call it,
>needs counter pressure to help. Sometimes this can be done against the jaw,
>but the last time I saw this done the baby hated it. Otherwise, baby may
>need to be taken off breast :( and suck trained with a finger, which can
>apply counter pressure during feeding without injury. Also, damage from this
>type of pressure can result in a radiating pain such was described. When you
>mix thrush pain and nerve damage, it can be difficult to see what is what at
>first! (hindsight is always 20-20, isn't it?)
>
>As for the palate issue, if it stood alone, I would have put mom and baby
>into a position that placed baby above the breast rather than allowing the
>breast to hang by gravity into baby's mouth. This forces baby to be active in
>the nursing process, and baby is "forced" to take more tissue into his mouth
>in order to get an adequate hold on the breast! My favorite position: mother
>supine, baby on top in prone position. After L-O, baby can roll slightly to
>one side. Also, finger feeding is good for palate issues because the baby
>wants to pop the nipple into the bubble rather than taking it farther back,
>and finger feeding "desensitizes" baby to having something farther back in
>mouth. The initial problem is that such babies may gag at attempts to put
>more tissue further back.....
>
>I'm not as sure about the pumping situation, and am unclear from your post as
>to which double pumps she was using. I have seen that thrush can make
>pumping very painful, and sometimes manual expression is the best choice. At
>any rate, had she taken baby off the breast sooner, before extensive damage,
>I'll bet a lot of this wouldn't have happened. I don't love to take babies
>off the breast, but if we can't get breastfeeding to a reasonable degree of
>comfort pretty quickly, I will not allow a mom to get torn up like this;
>problems don't get solved this way.
>
>At least now she knows what products to avoid. She might consider doing a
>patch test for lotrimon in case she faces yeast with another baby and needs a
>treatment.
>
>At this point of weaning, I personally would handle it differently in that I
>would not encourage this painful nursing. Rather, I would encourage her to go
>back to a pump once she is healed (she's almost there, right? or am I off
>track here....). If she was using the Medela double system, take the blue
>silicone ring off to decrease the suction pressure if it felt/still feels too
>strong. Then pump and finger or bottle feed baby. If she had it in her, and
>I can understand that she doesn't now, I would just have her pump, slowly
>build supply back up, and allow those poor nipples to heal completely. Then,
>when baby's mouth has begun to relax, try again to get baby to breast using
>"bubble palate" positioning strategy.
>
>Kathleen, this is kind of sketchy and jumps around; it's all I have time for,
>but your story hit some points with me. Tell me what you think of my
>analysis, and I'm looking forward to reading others. :-)
>
>-Lisa
>
>------------------------------
>
>Date: Wed, 21 Feb 1996 14:50:28 -0500
>From: "Linda J. Smith, BSE, FACCE, IBCLC" <[log in to unmask]>
>Subject: Re: getting fussy babies to sleep
>
>You can't GET a fussy baby to sleep! First, fix the fussiness. Feed the
>baby, hold the baby, rock the baby, touch the baby, feed the baby again, etc.
> When the baby is feeling full and safe and tired, he'll fall asleep. Just
>like adults. Even elephant trainers know this.
>
>If the baby is not feeling safe, he won't sleep alone - just like adults
>often have a hard time sleeping alone in strange beds on trips. Most babies
>need to have a human next to them to feel safe, just like most married
>couples sleep better with their spouse in bed with them. Or at least the
>dog.
>
>If the baby isn't tired, she won't sleep either. Just like adults. If the
>baby is hungry, she won't sleep. Just like adults.
>
>Linda Smith, private practice in Dayton OH, noting that I still don't sleep
>through the night - why should babies? What's the big deal, anyway?
>
>------------------------------
>
>Date: Wed, 21 Feb 1996 14:50:09 -0500
>From: "Linda J. Smith, BSE, FACCE, IBCLC" <[log in to unmask]>
>Subject: Re: nipple damage and care
>
>Sue Huml, your comments are very good and I completely agree re: pain relief
>for damaged nipples being appropriate.
>
>I also agree with Kathy Dettwyler. I think we see so many cases of damaged
>nipples in North America because birth is managed so poorly with medications,
>epidurals, forceps, separation of mom & baby, suctioning, etc etc. It's a
>wonder any of these kids can suck at all, much less properly. If we did to
>athletes what we do to babies at birth, world records would be at 1920's
>levels instead of where they are today.
>
>One more time - the baby's suck is controlled by muscles which must have
>intact innervation, sufficient caloric support, good blood supply and no
>pharmacological or other insults to contract sequentially and smoothly. PLUS,
>no Super-stimulus causing a reverse muscle contraction pattern (i.e., no
>teats or suctioning) to protect the airway. Most early nipple damage is
>caused by mechanical forces inappropriate to the nipple tissue, where the
>forces are excessive, improperly placed and/or for extended time.
>
>All birth medications (repeat - ALL) have been documented to affect the baby.
> All mechanical and chemical interventions used during birth affect the
>central nervous system and one or more of the 6 cranial nerves that control
>suck-swallow-breathe. If you mess with the baby, you get messed-up suck and
>damaged nipples. This is not new information, folks.
>
>Linda Smith, same song, one more time
>Dayton, OH private practice
>
>------------------------------
>
>Date: Wed, 21 Feb 1996 14:50:38 -0500
>From: "Linda J. Smith, BSE, FACCE, IBCLC" <[log in to unmask]>
>Subject: Re: Horrible case report
>
>Kathy Bruce,
>
>If this were my client, I would have advised getting this baby off the breast
>and mom pumping very early. Sounds like the baby had a terrible suck. In
>situation like this, when direct effective breastfeeding isn't happening, go
>for indirect feeding of mom's milk until the problems in both are fixed. Get
>mom pumping and feed the baby with another device while each is treated
>separately - mom for the nipple stuff, and baby for the poor sucking
>response. Keeping an ineffectively-feeding baby at the breast is
>counterproductive. You know the old adage - if it's not working, try
>something else.
>
>Linda Smith, private practice in Dayton OH
>
>------------------------------
>
>Date: Wed, 21 Feb 1996 15:21:30 -0500
>From: Susan Pszenitzki LLL Leader applicant <[log in to unmask]>
>Subject: <No subject given>
>
>gy Robin
>
>Peggy Robin can be reached at [log in to unmask] If you have AOL this book
>has raised quite a lot of controversy in the breastfeeding folder in the
>Parenting Forum of the National Parenting Center (Keyword --PIN)
>
>------------------------------
>
>Date: Wed, 21 Feb 1996 16:17:52 -0500
>From: Kathleen Bruce <[log in to unmask]>
>Subject: errors
>
>Note re: errors on Lactnet. I am receiving on average of 10 digests/day of
>300 lines each of errors from different people whose addresses are not
>working...full mailboxes, etc. If you *know* that your server is going to be
>down..etc...Please do me a favor and go nomail. This is very important.
>Addresses that bounce frequently, I will consider a problem..and I may have
>to filter out addresses that continually malfunction. Your consideration of
>this problem will be appreciated by me.
>
>Thanks. Kathleen
>Kathleen B. Bruce, BSN, IBCLC, LLLeader, co-owner Lactnet, LLLOL, Corgi-L
>LACTNET WWW site: http://www.mcs.com/~auerbach/lactation.html
>Personal WWW page: http://together.net/~kbruce/kbbhome.html
>
>------------------------------
>
>End of LACTNET Digest - 21 Feb 1996 - Special issue
>***************************************************
>
>
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