I attended the AAP convention in New Orleans representing ILCA at the IBLCE
booth. I will give a brief over-view of my experience.
The big news was that there was a vastly increased focus on the subject of
bfg compared to last year. There were two 3-hr sessions, one a large
plenary with Q&A afterwards. Both very well-attended.
Dr.Lawrence Gartner gave a wonderful plenary presentation called: The Ten
Things about Breastfeeding They Didn't Teach You in Medical School. #1. BFG
is good for Moms as well as babies (new research on osteoporosis,ovarian and
breast cancer) #2. BFG moms don't have to drink milk (if they have family hx
of atopy) but that they can if it doesn't bother baby #3. BFG should be
initiated within 1st hour of life, and skin-to-skin care should be
practiced. #4.Duration of breast feeds should not be limited. #5 Water
supplements are unnecessary #6. Frequency of feeding is probably more
realistically expressed as 10-12 feeds (not 8) per 24 hrs. #7 Every BFD
baby does NOT need Vit D.-- very dark skin, no sunlight may. #8 Exclusive
bfg for 6 months is optimal and addition of comp. foods from 4-5 mo is too
early for most babies. #9 Hepatitis, maternal fever and maternal infections
are NOT contraindications for cont. bfg. Hep C is not contraindicated. HIV
and HTLV are prob. contraindicators in devel. poplulations. #10. There is
no need to wean by 12 months. There is no outside limit on time when
nursing is good for children.
The following statement made by Dr. Gartner also appeared in the convention
newsletter which was delivered to each registrant: "There is no evidence
that prolonged breastfeeding psychologically harms the child, and althought
there have been no formal outcomes studies in large groups, experts suspect
the practice may actually be psychologically beneficial. My clinical
impression is that babies breastfed for long periods of time are much more
independent, self-reliant and secure than those who are breastfed for
shorter periods of time." Dr. Gartner hinted that the new AAP
recommendations (which will appear in 1997 Dec. issue of PEDIATRICS) will
substantially lenghthen the recommendation for breastfeeding.
James Mckenna presented an amazing lecture which included his sleep study
videos and provoked much discussion. He had the courage to say that shared
sleep was the biological expectation of the baby and that to ignore this
presented a moral dilema. Kay Dewey shared her work on growth and that of
Bo Lonnerdalh on the subject of the need for iron supplementation (prob.
unnec. prior to 9 mo. pp). Dr. Marianne Neifert and Dr. Linda Black also
gave fabulous presentations. They mentioned working with LCs, and both LCs
and LLL were mentioned favorably. Dr. Black used a slide which described
formula as a health risk. She promoted BESTFEEDING, Dr Hale's book, Amy
Spangler's parents guide, and The BFG ANSWER BOOK, saying the docs all
needed to obtain and use these guides. Dr. Neifert gave great practical
management instruction.
We owe a huge debt of gratitude to the work of these MDs and PhDs whose
thorough science and personal authority have represented breastfeeding in
such a powerful light to this influential body. We must never lose sight of
the fact that peers speak best to peers. That's as true of us as of doctors.
The traffic at the booth gave me the opportunity to get a feel for what
individual physicians, PAs and some RNs are experiencing in their
interactions with LCs in communities. Often I heard praise, and sadly, also
complaints. The issue of doctor bashing came up again and again. It
creates enormous reluctance to work with a profession whose practictioners
are so indiscrete as to make nasty public comments about doctors to clients,
etc. These MDs are our referral source! Each one of us really needs to
examine our consciences about this. Many of the MDs are considering
certification for themselves, which is I think positive. The issue of
qualifications came up frequently. We really need to work on more
supervised clinical hours. It is also clear that we need to pay constant
attention to perfecting more techniques so we can deliver the goods when it
comes to effective helping. We are getting attention, but if we want to be
taken seriously we have a long way to go to prove ourselves.
Hope this brief over-view gives you a flavor of the convention. Keep a look
out for the Dec. issue of PEDIATRICS.
Barbara
Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html
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