>To: [log in to unmask]
>Subject: comments on infant feeding article
>Date: Wed, 26 Jan 2000 17:53:52 PST
>
>Web MD,
>
>I have some comments on the article at your website
>[ http://my.webmd.com/content/dmk/dmk_article_5461840 ] entitled "Advising
>Parents on Feeding Healthy Babies."  I am an RN, and board certified
>lactation consultant with a graduate degree in parent-child health. I work
>in a hospital lactation program, coordinate the Louisiana Breastfeeding
>Mediawatch Campaign (a national campaign), and I live and breathe
>lactation. I have a few quibbles with your article.
>
>After reading your advertising and sponsor policies, and your editorial
>integrity and ethics positions, I feel comfortable that you do indeed want
>to be credible, authoritative, and up to date for health care providers and
>parents. Therefore I feel your article needs to be updated right away. Here
>are the relevant parts needing revision, in my opinion:
>
>I, and I believe every one of the lactation experts that I know, would
>disagree with the advice to limit early breastfeeding to 4-5 minutes. In
>fact, the current recommendation is for UNRESTRICTED BREASTFEEDING FROM THE
>VERY FIRST FEED. This pertains to term, healthy newborns, of course.  Also,
>breastfeeding should be expected to occur about 10-14 times in 24 hours,
>which is more frequent than the 8-10 times you recommend. The very minimum
>number of feeds should be 8-9.  The old advice to nurse on both sides at
>every feeding is no longer being given. Babies can nurse as long as they
>desire on the first side and then be OFFERED the second side to suckle if
>they are still hungry. If not, the baby can take the second side at the
>next feeding.
>
>While I agree that certain nutrients (like types of fats and vitamins) can
>be INFLUENCED by diet, research shows that dietary perfectionism can and
>should be de-emphasized.  And stating that diet influences quantity of milk
>produced is really untrue (unless a mother is EXTREMELY undernourished).
>Effective MILK REMOVAL FROM THE BREASTS is what drives amount of current
>and future milk production.
>
>Your statement that breast size and nipple shape are irrelevant to the
>course of lactation is mostly true. However, knowledgeable lactation
>consultants know that sometimes an ususual breast shape or marked breast
>assymetry are markers for lactation trouble. Likewise, a history of breast
>surgery would be a "red flag," and certain nipple conditions can lead to
>breastfeeding challenges as well.  Your article goes on to say that breasts
>and nipples should be examined prior to the birth. While I agree with this,
>in your article this part was confusing.
>
>There were many, many excellent parts of the article. I especially liked
>the explanation and endorsement of the infection-fighting properties of
>human milk, the few conditions and medications that contraindicate
>breastfeeding, and the statement that "poor nursing technique" (which can
>be corrected by knowledgeable and supportive providers) leads to most
>breastfeeding difficulties. Therefore, I hope that you will update your
>site asap. May I suggest utilizing the very learned and collegial
>physicians who belong to the Academy of Breastfeeding Medicine. Address is
>P.O. box 15945-284, Lenexa, KS 66285-5945, email [log in to unmask]
>http://www.bfmed.org
>
>Laurie Wheeler, RN, MN, IBCLC
>Coordinator, Louisiana Breastfeeding Mediawatch Campaign
>Violet LA 70092
>

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