Pat-I have had chronic hives for 8 years now-possible causes can be immune
system disturbances, foods she's eating especially salicylate products & those
with tartrazine, abnormal estrogen levels, some drugs, insect bites, plant
allergies, pet allergies, sinus problems, heat, coldness, stress, physical
exercise, and the unknown. Personally I have the unknown kind which get worse
when I'm hot, have an infection, or eat certain foods. I've had every test
imaginable and still no cause found or effective cure as is the case
frequently with hives. My ideas: when breastfeeding the mother tends to get
warmer and even sweaty and her estrogen levels may be off. See if she's does
anything different when she's nursing like use a different detergent,
different softner, different bleach, eats things she usually doesn't or eats
alot more of certain foods when nursing or pregnant, or maybe goes out in the
sun more with baby. Any of these things could be culprit and sometimes they
never know. What works fairly well for the itching & heat of hives: Benadryl
cream(sprays are too sticky and pills make one too drowsy). She may need some
H1 antihistamines & possibly a combo of H1 & H2 antihistamines although these
don't work for me. If the hives get really bad she may need shortterm steroid
therapy(ie. a Medrol dose pack for 7 days) or a shot of epinephrine. I do not
know exactly which antihistamines are safe while breastfeeding-may want to
consult Dr. Hale on that matter. Hopefully they aren't too bad for her. If
they go away when she stops nursing &/or when not pregnant, I would really
suspect anything different she does or ingests, the hormone connection, and
the cholinergic uticaria d/t heat. No offense but she should probably see an
allergist/immunologist over an internal medicine or family doctor just because
they're likelier to have more experience with hives. Hope this helps & good
luck to you & the mom!!!
Debi Savage RN, BSN, SNM(hopefully IBCLC after 7/96!) from Westmont,
IL(near Chicago)
----------
From: Lactation Information and Discussion on behalf of Automatic digest
processor
Sent: Tuesday, June 04, 1996 9:58 PM
To: Recipients of LACTNET digests
Subject: LACTNET Digest - 4 Jun 1996 - Special issue
There are 19 messages totalling 433 lines in this issue.
Topics in this special issue:
1. brain growth
2. ilca '97
3. Metoclopramide dosages
4. Medications in Mothers' Milk
5. Pay Scale for Hospital LC's
6. ABM
7. dilantin
8. N of HCL?
9. Hives and Breastfeeding
10. Rose Marie's questions
11. references for suck training (2)
12. Pumping mom with decreased supply
13. Breastfeeding rashes?
14. LACTNET Digest - 4 Jun 1996 - Special issue (2)
15. NICU baby
16. knock off formula
17. WIC subcontracting
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LACTNET WWW site: http://www.mcs.com/~auerbach/lactation.html
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----------------------------------------------------------------------
Date: Tue, 4 Jun 1996 16:51:28 -0400
From: Janice Conover LLLL <[log in to unmask]>
Subject: brain growth
I need help finding information or references about brain growth in breastfed
children beyond the first year. I also know of people who see no value of
nursing beyond the first year, and this would be another reason to add to the
list if brain developement and breastfeeding are closely tied as they are in
the first year.
TIA,
Janice Conover in Racine, WI, where summer disappeared and left us with 50
degree temps
------------------------------
Date: Tue, 4 Jun 1996 17:10:05 -0400
From: "L. Jonathan Kramer, P.E." <[log in to unmask]>
Subject: Re: ilca '97
On Mon, 3 Jun 1996 09:16:15 -0400, Patricia B. Drazin wrote:
> not a rumor.. it is true.. the date is in August...
Oh, come on, who'd schedule a conference in a hot, wet climate in
August? Are they trying to avoid a crowd?
Jonathan
****************************************
* L. Jonathan Kramer, P.E. *
* Graduate Breastfeeding Counselor and *
* Student Lactation Consultant *
****************************************
------------------------------
Date: Tue, 4 Jun 1996 16:12:20 -0500
From: Tom Hale <[log in to unmask]>
Subject: Re: Metoclopramide dosages
To: Julie H.
Re: Metoclopramide dosages
Prior studies have indicated that the optimum metoclopramide dosage for
increasing breast milk production lies between 30-45 mg/day divided in
three or four doses, or more commonly 10mg three times daily.
Doses less than 20 mg / day were ineffective. Doses higher than 30 mg may
tend to produce more side effects, particularly depression. Studies seem
to indicate that mothers whose supply is low, but present, do better
with Reglan than those whose supply is exceedingly low or not present.
As for current studies, I'm not aware of any. As for the other "unknown"
herbal substances, who's to know what these things are.
Tom Hale
------------------------------
Date: Tue, 4 Jun 1996 17:38:20 -0400
From: Kathleen Bruce <[log in to unmask]>
Subject: Medications in Mothers' Milk
I have been asked to post this, since it has been requested frequently.
To order Tom Hale's book Medications in Mothers' Milk,
"Medications and Mothers' Milk" can be ordered by phone
>800-378-1317 or 806-358-8138, or mail ordered from
>
>Pharmasoft Publishing
>4606 Oregon
>Amarillo, Tx 79109
call them for the price please.
Kathleen
>
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet (In Vermont)
LACTNET WWW site: http://www.mcs.com/~auerbach/lactation.html
LACTNET archives http://library.ummed.edu/lsv/archives/lactnet.html
------------------------------
Date: Tue, 4 Jun 1996 17:57:09 -0400
From: cynanne <[log in to unmask]>
Subject: Pay Scale for Hospital LC's
In reply to Becky Krumwiede:
I am a LC in a small rural hospital (we have 8 PP beds), I was an RN there
for 5 years before I became an IBCLC. I make the same pay for LC as I do
for RN - except that as RN I get diferential for evenings, weekends and
charge. I am also only evaluated as an RN, not as an LC. I dont think this
is fair because I have a lot more duties as LC.....
If any one out there has seperate pay for the seperate jobs--pls let me know
how it works at your hospital.
TIA
Cindy
*~*~*~*~*~*~*~*~*~*~*~*~*~*~*
*[log in to unmask] *
*~*~*~*~*~*~*~*~*~*~*~*~*~*~*
------------------------------
Date: Tue, 4 Jun 1996 18:09:52 -0400
From: Gina Stubbs <[log in to unmask]>
Subject: ABM
Someone wrote about objecting to the term "artificial breast milk." I
assume this person thought that ABM was an acronym for this. It is my
understanding that ABM= Artificial Baby Milk-- not breastmilk! Am I the
one who is mistaken here?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
\ o / __o __| \ / |__ o__ \ o /
| /\ ___\o \o | o/ o/___ /\ |
/ \ | \ /) | ( \ /o\ / ) | (\ / | / \
Heidi Murphy <[log in to unmask]>
Peyton's Mommy since 12-20-94
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
------------------------------
Date: Tue, 4 Jun 1996 18:15:38 -0400
From: "Patricia B. Drazin, IBCLC" <[log in to unmask]>
Subject: Re: dilantin
barb:
dilantin is aap compatable.
patricia
------------------------------
Date: Tue, 4 Jun 1996 18:15:38 -0400
From: "Patricia B. Drazin, IBCLC" <[log in to unmask]>
Subject: Re: N of HCL?
Jon:
I do not understand the quantity of N......
Patricia
------------------------------
Date: Tue, 4 Jun 1996 17:40:16 -0500
From: Patricia Gima <[log in to unmask]>
Subject: Hives and Breastfeeding
Lactnetters,
A mother b'feeding her third child broke out in hives two days post partum.
The first location, with blisters, was abdomen and chest. After this
initial stage she now, at three weeks pp, has a rash "all over"--legs arms
etc. Having had "pregnancy hives" with her first child she inquired of her
ped. whether the hormones of b'feeding could be causing it. This is the
first child she has b'fed. He doesn't know but is considering the
possibility.
What do you think? (other than any thing that is different this time is
probably caused by breastfeeding)
Pat Gima, IBCLC (Milwaukee)
------------------------------
Date: Tue, 4 Jun 1996 18:53:09 EDT
From: "Jeanette F. Panchula" <[log in to unmask]>
Subject: Rose Marie's questions
Rose Marie,
I have some material you may be able to use - but tried to write to you
directly
and was unable to reach you. Please send me your Snail-Mail.
Jeanette Panchula, BSW, LLLL, IBCLC, RN
[log in to unmask]
------------------------------
Date: Tue, 4 Jun 1996 19:14:57 -0400
From: Attie Sandink <[log in to unmask]>
Subject: references for suck training
To all:
Other than a Wolf and Glass's book is there any other research documented on
suck training? People like studies better than good results.
Attie Sandink RN. IBCLC. <[log in to unmask]>
------------------------------
Date: Tue, 4 Jun 1996 19:23:52 -0400
From: Attie Sandink <[log in to unmask]>
Subject: references for suck training
To all:
I have lost the Email address for ILCA home study modules and need to ask an
urgent question.
TIA
Attie Sandink RN. IBCLC. <[log in to unmask]>
------------------------------
Date: Mon, 3 Jun 1996 19:43:41 -0700
From: John Throckmorton <[log in to unmask]>
Subject: Pumping mom with decreased supply
You might try hooking her up with a graduate of nicu who has =
transitioned home to get some perspective on the current problem. If =
she is willing to take 3-4 days to concentrate on pumping, she may be a =
candidate for Reglan short term to give things a boost.
I tend to approach the whole thing from "let's not shut any doors before =
you are ready" and if she keeps pumping , even this much she is =
contributing to her children's health and may, possibly be able to =
increase supply later. This mom sounds like she has a lot going on-she =
needs more support, probably less advise. There may be more chance of =
postpartum depression due to the situational stressors, you can check =
for that if you get to see her. Good luck
------------------------------
Date: Tue, 4 Jun 1996 21:01:00 EDT
From: "Melissa L. Brancho" <[log in to unmask]>
Subject: Breastfeeding rashes?
Any chance that the hormone levels of breastfeeding can trigger prolonged skin
reactions in certain moms? I have persistant skin rashes that are exactly the
same as I have had while I was pregnant but since I am bfing for the longest
period I ever had before, I have noticed that they NEVER completely go away as
they did during pregnancy. Is there any studies on this? Anyone else have
any
information on this?
I have had a mom of a preemie (born at 33 weeks) who broke out with PUPP one
week pp and was finally given a correct diagnosis at 4 weeks pp and was
treated
with hydrocort. cream. She has had perisistent and repeat yeast infections
since birth that I never thought may be linked until now. I also have had
problems with yeast when hormonal changes are going on (since my daughter has
be
dropping bfings, they become more frequent). Seems to be a connection for me?
Anyone have more scientific information? In cow town, there is not much
material available and I am not seeking personal advice for myself, just
really
a looking for information.
Melissa Brancho
------------------------------
Date: Mon, 3 Jun 1996 21:05:56 -0400
From: john walker <[log in to unmask]>
Subject: Re: LACTNET Digest - 4 Jun 1996 - Special issue
Hello!!!!
My name is Laura Walker and I have been an RN for 18 yrs. 15 of it has been
spent working with mothers and babies in the hospital. Breastfeeding has
always been a passion of mine and am now the hospital's LC. I am both
challenged and overwhelmed every day by the in house moms, those that visit
with difficulties and phone calls. I love what I do. Each mom and baby is
a learning experience and I realize more and more how unique and individual
each one is. The books present a knowledge base to draw from then the
detective work begins. More challenging is the education of the nursing
staff which over the last year has been slow and painful for some. Being an
LC, you get more than you bargained for sometimes and develop pretty thick
skin. What a wonderful growing experience for me! I look forward to
reading and sharing information with all of you.
Also, I've been married to a wonderful man, John for 18 yrs. His support of
my efforts has been wonderful. Our daughters are 16 and 13 - more growing
and learning experiences for all of us - need I say more ? Oh yes, they
were both breastfed.
Laura Walker RNC, IBCLC
>
>
>
>
--
Registered ICC User
check out http://www.usefulware.com/icc.html
------------------------------
Date: Tue, 4 Jun 1996 21:16:52 EDT
From: "Jeanette F. Panchula" <[log in to unmask]>
Subject: NICU baby
Help fellow Lactnetters - more knowledgeble than I by far when it comes to
NICU:
I've been working mostly for the "baby friendly" program in our hospital and
with healthy (more or less) full term babies and helping moms whose babies
were
transferred to NICU for the usual infections, prematurity, etc.
However, this case brings a situation that I have not handled yet, and I'd
like
your input.
Mom delivered her second baby by cesarean birth after MD discovered slow
fundal
growth (mom had skipped some OB visits, I was told, as her previous pregnancy
was unremarkable and she didn't want to miss work.)
[To further explain what you may consider irresponsible behavior - here MD's
don't give appointments. You come on a first-come first-served basis and you
miss a whole day every time you need to go to the MD. Which is also why I'm
behind on my own checkups.]
"Tom" was born at 2 lbs 12 oz and has had all sorts of chromosomal and
infection
checkups. So far the only diagnosis is "Asymetrical Intra-uterine Growth
Retardation". And Asymmatrical he is. The head seems exceedingly large for
his
body, (his body looks to me similar in size to his NICU neighbor who is 30
wks.) which if I remember my nursing school books is actually a good sign that
the baby's head (and brain) grew even at the expense of the rest of his body.
He is now 3 lbs, the parents tell me they were told he is 34 weeks Gestational
Age. He has no respiratory problems or any other problems after many tests.
However, he is being fed by Nasogastric tube as he has "no suck" according to
the MD and nurses. Parents asked me to see him, which is how I ended up doing
an assessment.
These are my findings - but I would love to have some input into what else to
assess or what else to do for him:
1. Lower jaw is receeded, appears to be underdeveloped.
2. Hard palate seems very high.
3. Weak infrequent sucks elicited with finger stimulation, and only once did I
see a swallow.
4. Cup feeding wakened him and he appeared to try to want the liquid (mom's
milk
- she's doing a great job maintaining milk supply.) in his mouth, but again no
swallow.
I wonder if the presence of the NG tube - so large in such a small throat -
would inhibit the swallow. In fact, could it be causing the problem of no
swallows? Tom seems to have a very weak gag reflex, which I assume could be
caused by the constant presence of the NG tube. - or am I all off base? HELP
I assume he needs a trained OT or PT, but there isn't one with NDT training in
our hospital (in fact I only know one in PR). I would dearly have loved to
attend the suck conference held recently in Arizona, but the cost of travel
from
PR added to the conference and stay... What can I do for him? And more
importantly - what should I be very careful to avoid? - First Do No Harm!
Thanks for your help!
Jeanette Panchula, BSW, LLLL, IBCLC, RN
[log in to unmask]
------------------------------
Date: Tue, 4 Jun 1996 21:39:51 -0400
From: Kay Hagan-Haller <[log in to unmask]>
Subject: knock off formula
This morning on Donahue the discussion was "knock off" items and how they
harmed the consumer. I was not really concerned that someone was making
"fake" P**wer R**n*er Toys or watches or bluejeans...what got to me was
lower quality formula! The Food and Drug Administration has discovered a
much lower quality with conterfeit labels. There were companies buying
formula at reduced rates by saying they would be donating to third world
countries. They turned around, relabeled the cans and sold it to "mom and
pop" type stores at the regular price and made money. Then they figured out
they could just make the formula themselves and make MORE money. There is
no proof that any babies were harmed in any way--yet... I wanted to call and
tell them that if the drug companies weren't "knocking off" breastmilk by
making ABM to start with, this could not happen!!! Just thought you might
be interested.
Kay Hagan-Haller, LLL Leader and mother of 5 breastfed brilliant children
[log in to unmask]
I am only one, but I am one. I cannot do everything, but I can do
something; and what I should do and can do, by the grace of God, I will do.
------------------------------
Date: Tue, 4 Jun 1996 20:10:01 -0700
From: David Matthews <[log in to unmask]>
Subject: WIC subcontracting
Hi, Rose Marie:
I am a nurse practitioner/IBCLC for Kaiser Permanente, the grandaddy of
all HMOs and I subcontract with a marvelous WIC. I have trained about 12
peer counselors to do the very thing you are starting to do---phone
calls at various intervals with a line of questioning. We have had great
success with women accepting our help. You might try the peer counselor
route. A lot of good stuff is out there to help you develop a
program---ask ILCA for resources, look at the Learning Curve catalog,
ask your WIC director for all the goodies on peer counselor programs. I
couldn't do my job without my wonderful peer counselors. E-mail me
personally for our curriculum.I will need you address as well.
Rebecca Matthews, RNP, MNSc, ACCE, IBCLC
------------------------------
Date: Tue, 4 Jun 1996 22:58:07 -0400
From: Mimi O'Donnell <[log in to unmask]>
Subject: Re: LACTNET Digest - 4 Jun 1996 - Special issue
Hi everyone,
Well I guess I need to re-issue my request. I only had one reply ( thank you
) and one person that asked me to share with them the answers I got. Well I
need a little more info. I requested info. on what everyone is currently
reccomending for thrush, both mother and baby. I am very interested. I
specifically want to know about Diflucan (sp). Effects on baby etc.
I also want to say thank you to those that responded to my mentoring plea.
I'm starting to get back into the swing of things. I've been more or less not
helping moms for the past 5 months. I felt so out of practice but it's coming
back. I've done home visits with 2 moms recently and they both had positive
outcomes. Yea! 2 more things I want to say, I'm so sorry for the L.C. that
had the mom call about the baby with sids, that must have been hard on you as
well as the parents. I have always loved when moms bring the baby in for a
"look how great" session. My thoughts are with you and the parents. I seem to
also remember someone talking about when things don't go well. I've had my
share I think we all have. Like you pointed out, you have to remember all
those that you do help. I also keep an " I love me" book. In it I put cards
from moms and pictures they send me of their babies. I also have things like
my first meeting notice ( LLL) and my kudos from the Red Cross for my BFing
classes. When I'm really down and feel like BFing rates will never go up and
I see women with bottles all day long ( very depressing to me ) I get my book
out and remember the nervous mom I spent % wks with. Yes, % weeks! She was
very unsure of everything. She now has a second child and has no problems. It
makes me feel good and reminds me that I do make a difference one mom at a
time. Well that's it, again please let me know what you all are reccomending
for thrush.
Thanks,
Mimi in Columbia S.C.
------------------------------
End of LACTNET Digest - 4 Jun 1996 - Special issue
**************************************************
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