I can certainly appreciate Marie Davis' frustration when she returns a
client to a physician, but the MD then looks to her for what to do...

However, I do not feel that a recipe book including management protocols
would be all that helpful.

One of the big dangers of a cookbook (of any kind!) is that everyone
follows the recipe (more or less) exactly, regardless of the
appropriateness of doing so.  Example: cooking as one would at 100 ft above
sea level when one is above 5,000 ft is NOT going to result in the same
outcome.  Substituting sea salt for the regular old kind will cause a
change in taste; substituting a sugar substitute in the same concentration
as was called for if using sugar will surely not taste the same...

Furthermore, with regard to lactation difficulties, every management
situation requires individualization of recommendations.  What would work
for one mother would be the worst possible suggestion for someone else.

A case in point if FTT.  There are numerous reasons why this might occur,
including, but not limited to....

* primary breast insufficiency inthe mother
* early breastfeeding mismanagement that is not corrected
* mother following severely limited access of breast to the baby
* neurological problem with the baby (transient or permanent)
* illness in the infant
* placental fragment retention in the mother (but not in all; some respond
with excess milk!)
* prematurity of the infant

and so on

A book that discusses various ways of manageing problems would be something
I could live with, but a cookbook that provides only one recommendation per
problem?  No way!  I hope Marie is thinking in terms of the former rather
than the latter....

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Kathleen G. Auerbach,PhD, IBCLC (Ferndale, WA USA) [log in to unmask]
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