Dear colleagues,
I was phoned last night (off duty) by an inpatient post partum nurse who had just discovered that his patient s/p SVD with pitocin augmentation of labor (for 2 hours) has a history of b/l nipple hernia repair two years ago. Scars are 360 degrees around areola b/l and also about 1 inch long scars under the breasts at 5 and 7 o'clock b/l. I know nothing else so far. I will see this patient tomorrow before she is discharged and have done some internet research, but would also very much appreciate any advice to this new IBCLC from you all. I had not heard of nipple herniation prior to this phone call. Thank you.
Jennifer Cooper, RN, BSN, IBCLC
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From: LACTNET automatic digest system <[log in to unmask]>
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Sent: Saturday, October 6, 2012 6:00:13 AM
Subject: LACTNET Digest - 4 Oct 2012 to 5 Oct 2012 (#2012-709)
There are 4 messages totaling 178 lines in this issue.
Topics of the day:
1. Prolactinoma and galactogoues
2. Teen mother school programs
3. Breastmilk verification (2)
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Date: Fri, 5 Oct 2012 19:53:53 +1000
From: Naomi Hull <[log in to unmask]>
Subject: Prolactinoma and galactogoues
Hi all,
have seen a Mum in our clinic this week that has stopped breastfeeding her 3 month old due to earlier difficulties with untreated Anterior Tongue Tie. She has come to us for discussion of this, and has now had the tie snipped. She has expressed some interest in relactating, which is great.
Only problem is she has a prolactinoma, and had been taking Dostinex prior to falling pregnant. Her prolactin levels were checked at 6 weeks post natal and were only 7!! This is when she was still breastfeeding (with difficulty).
She was told she could not take galactogogues because of her prolactinoma. Does anyone know what is considered a safe prolactin level in someone with a prolactinoma?
I am assuming that because she was given the OK to go off Dostinex and breastfeed, anywhere up to normal lactating levels would be OK? But is there a problem with the stimulation itself? rather than the actual levels?
Naomi Hull
IBCLC, RN
Stafford Heights Lactation Clinic
Brisbane, Qld
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------------------------------
Date: Fri, 5 Oct 2012 06:27:31 -0700
From: Jeanette Panchula <[log in to unmask]>
Subject: Teen mother school programs
Jodine,
Teens have been a big issue in our country, too - at least in the states I have lived!
In my experience, the Department of Education of the local district has carte blanche, with very limited directives from statewide or national Departments of Education.
Just like the SIDS programs are often led by people with passion due to losses in their own lives, those running the Education Departments have a passion about one thing: EDUCATION. They want the student to graduate with as little interruption as possible for their baby (in our country the schools are paid per body present per day, which gives them a great incentive to demand early return to school).
I know there are some wonderful, kind teachers, but the system treats students who become pregnant as a nuisance that must be dealt with - at times pretty much forcing them to a special educational program or school (so as not to "contaminate" the other students?) - one that would delay their graduation or meeting pre-college courses, if they wished to continue in their original school while pregnant.
When babies are born, students are expected to return within a few days or weeks - and IF day care is provided it is used as a way to teach ALL students how to care for babies by scheduling a rotation to the day care - and those students that are there feed the babies - whether they are theirs or not. What a missed opportunity! I'd love to bring the "Secrets of Baby Behavior" into those classrooms! (www.secretsofbabybehavior.com)
Of course there are the exceptions - I'm sure you'll hear about them - but it seems that those who are part of the "system" and want to help young parents take a break of a year to learn about their baby or want to take shorter days - even at the cost of taking a bit longer to complete their studies - have few if any options.
Our current data shows there are fewer adolescent pregnancies, but in my experience those teens have as little support to learn about parenting as any of the previous generations! We seem to have evolved even more slowly in that front compared to hospital/childbirth.
In my opinion, one of the big reasons to support a breastfeeding teen is that her baby learns who really is mom - even if grandma provides a lot of the care. It seems as if "The system" would really like it if grandma would just take over (never mind the trauma of that baby being ripped from "mom" when the teen grows up and leaves home), or just make believe the baby does not exist.
By the way the California Nutrition and Physical Activity Guidelines for Adolescents, designed to assist the Adolescent and Family Life Program (AFLP) case managers, has updated their "Infant Feeding Guidelines." See the link from: http://www.cdph.ca.gov/healthinfo/healthyliving/nutrition/Pages/TeenGuidelines.aspx
Jeanette Panchula, BSW, RN, PHN, IBCLC
California, USA
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------------------------------
Date: Fri, 5 Oct 2012 13:43:53 -0400
From: Lisa <[log in to unmask]>
Subject: Breastmilk verification
Would those of you using you current medication administration system to verify breastmilk email me off line. We are looking at how this integrates within the system as well as any problems you may have had in implementation. Did you have any trouble with the pharmacy in using the system for this purpose?
Thanks,
Lisa Enger RN, BSN, IBCLC, CEIM
Sent from my iPad
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Date: Fri, 5 Oct 2012 15:11:24 -0400
From: Pat Young <[log in to unmask]>
Subject: Re: Breastmilk verification
Probably the best place to ask is Children's Hospital of Philadelphia (Diane
Spatz) Pat in SNJ
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End of LACTNET Digest - 4 Oct 2012 to 5 Oct 2012 (#2012-709)
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