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From: LACTNET automatic digest system <[log in to unmask]>
Date: Sun, 10 May 2009 00:00:07
To: <[log in to unmask]>
Subject: LACTNET Digest - 8 May 2009 to 9 May 2009 (#2009-502)
There are 4 messages totalling 282 lines in this issue.
Topics of the day:
1. 7 month drop in supply
2. Breastfeeding on United Airlines
3. Need help with recurring mastitis/breast pain
4. A watershed for Australia
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Date: Sat, 9 May 2009 00:51:29 -0400
From: "Jennifer Tow, IBCLC" <[log in to unmask]>
Subject: 7 month drop in supply
Kathy asks about an apparent sudden drop in milk supply at 7 mos. Since we do not know if mom
is pregnant, there is still a lot of conjecture of course. But, has anyone considered that there might be a
problem with the pump since she believes the baby is content at breast? OTOH, he may only appear
content if he is getting a lot of solids. I am wondering why you would suggest a drug with very negative
potential side effects when there are so many safer and more effective herbs?
I am also curious about this response from Maria:
"What you want to know is how much and how often solid food is given to this
child. This is common with mothers who feed solids too much, too frequently
which will quickly lead the supply down. Done correctly, milk reduction is
naturally slow process with the baby dictating the supply. Remember, the
staple of the baby's diet is and should be, breastmilk for the first year.
The solids should not replace a breastfeeding. Solids take up space and
nutritionally don't pack the punch breastmilk does. So if she is feeding
solids to this baby more than once a day and more than a tablespoon I would
suggest she back off the solids and nurse as much as possible..the baby
should drive that supply back up. Caution her from undo dieting or reducing
her carbs.(which is also common with moms at this time)...I would bump her
healthy carbs to over 50% of her daily intake and make sure her caloric
intake is adequate."
I of course agree that solids could be the culprit. I would also evaluate the baby's actual readiness--if
he is taking solids in a spoon rather than self-feeding, he is likely overfed and/or not ready. OTOH,
when moms drop supply where solids are not the cause, I would rather see baby get solids than AIM
while mom is away.
My question, though is about the comment on carbs. Most people have no idea what healthy carbs are
and given this advice will eat more grain products, not more vegetables or nutrient-dense foods.
Nutrient-density is the key to a healthy diet, not whether the food is defined as a fat, protein or carb, so I
am wondering which foods you are specifically suggesting? French fries are complex carbs, but are
nutrient-poor. If I see diet as implicated in loss of milk supply, mom usually needs more vegetables, EFAs,
nuts, seeds, avocados, coconut, dark leafy greens and possibly beans. I will often suggest moms have a
smoothie for breakfast that includes a green powder and possibly a protein powder as well as sources of
EFAs, like seeds to really pack in the nutrition.
Jennifer Tow, IBCLC, CT, USA
Intuitive Parenting Network, LLC
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------------------------------
Date: Sat, 9 May 2009 13:47:14 -0400
From: Jeanne Schneider <[log in to unmask]>
Subject: Breastfeeding on United Airlines
Hello,
Last night on a flight from Denver to Cedar Rapids Iowa on United Airline=
s my=20
daughter was trying to nurse her crying 9 month old (who by the way is an=
=20
exclusively breastfeed 33 week preemie). It is a bit of a long story, but=
the=20
main point is she was told by the flight attendant she should have=20
prepared "some other method" of calming her baby during the flight. She h=
as=20
filed a formal complaint and is waiting a response from the airline.
I know this has happened before and has been challenged legally. I am=20
interested in hearing from anybody who has personal knowledge of such cas=
es=20
as well as ideas for dealing with this. Air travel will be a frequent occ=
urence for=20
this dyad.
Thanks in advance for your thoughts.=20
Jeanne Schneider RN IBCLC
Kirkland Washington USA
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------------------------------
Date: Sat, 9 May 2009 14:34:06 -0400
From: "Beth W." <[log in to unmask]>
Subject: Need help with recurring mastitis/breast pain
Hi everyone, a friend of mine who is studying to become an IBCLC recommen=
ded
I ask you guys about my experience, as it's one that has stumped a couple=
of
LCs and a UCSF midwife so far.=20
I had a breast reduction in 2001 -- my nipple remained attached throughou=
t,
but I don't know much more about the surgery technique than that. I had a=
baby in March and have been nursing her for 9 weeks. I have not been able=
to
breastfeed exclusively, but we breastfeed first and then give her a bottl=
e
of formula and let her eat to satisfaction. I am taking domperidone (90
mg/day), fenugreek and goat's rue to boost my milk supply and build mamma=
ry
tissue.=20
In my third week postpartum I developed a fever and then swelling/pain in=
both breasts. I was diagnosed with mastitis and given a 14-day course of
keflex. (I am told that bilateral mastitis is rare, but I was using nippl=
e
shields at the time to help my daughter latch on to my flat nipples -- we=
are no longer using them -- and I suspect they caused the infection to
spread to both sides). I felt better within a few days and happily finish=
ed
my course of antibiotics. However, I had lingering sharp pains in my brea=
st,
particularly around the 7 o'clock area.=20
We stopped using the nipple shields sometime during this infection. Her
latch has since improved and is really good at this point, not causing me=
any pain/injury.=20
Three days after I finished the keflex, I had severe nipple and breast pa=
in
in my right breast. It was so bad it radiated into my back. I thought it =
was
my Reynauds -- I have vasospasms after nursing that I try to control by
keeping warm. But when I looked at the breast I saw that there was a huge=
red area near the pain, and within a few minutes I developed chills and
dizziness. I was diagnosed with mastitis yet again and given a 10-day cou=
rse
of dicloxacillin. Again, I felt better within a few days and finished the=
course of antibiotics. This time, I developed some skin irritation on the=
nipple including a blister (not a milk blister) that took time to heal, a=
nd
the outer later of skin on my nipple and breast peeled off a bit like a
sunburn. Also, the pain in my breast/nipple continued.=20
I also had an ultrasound of my breast at this time and no abscesses were
found. During the first round of mastitis, a culture of the milk in my ri=
ght
breast showed GBS, but during the third round, the culture only grew skin=
flora.=20
Five days after I finished the diclox, same routine -- exceedingly bad
nipple and breast pain followed by a wedge of redness and heat in the bre=
ast
that spread. This time I took 60mg ibuprofen immediately and did not deve=
lop
a fever. I was diagnosed with mastitis and put on 7 days of clindamycin. =
I
finished that round this morning and am worried the infection will just c=
ome
back.=20
In terms of care, during the first few days of each infection, I soaked m=
y
breast(s) in warm salinated water before feeds, massaged my breasts befor=
e
and during feeds, and took on a number of other self-care approaches,
including drinking a lot of fluids, trying to rest as much as possible,
taking echnicacea/Vitamin C/garlic for my immune system, and lecithin to
think milk clots (3,600mg per day to start - now trying double that). I h=
ave
also tried boosting my iron supplementation, taking homeopathic levels of=
phytolacca, and pumping. I seem to be able to drain my breasts well most =
of
the time -- there is one spot that does not resolve, but it isn't where t=
he
"wedge" starts and it hasn't changed size or shape in weeks. (Again, I ha=
ve
shown no signs of abscess).
For the breast pain, I took a two-week course of dicflucan and supplement=
ed
with grapefruit seed extract, thinking maybe it was yeast, but nothing ha=
s
changed. If anything the pain has gotten worse.=20
So here's my dilemma:=20
1) I don't know how to get rid of the mastitis and keep it gone
2) I don't know what is causing the breast and nipple pain=20
3) I don't know if the mastitis and pain are related or separate
I saw a UCSF midwife -- who is their leader on mastitis issues in postpar=
tum
care -- yesterday and she's stumped. She wants me to see a breast
specialist, which might help academically. I have some theories about wha=
t's
going on but want to keep them to myself for the time being because I wan=
t
to see what the LCs here have experienced that might be relevant to my ca=
se.=20
I am likely to start a course of B6 for the vasospasm to see if it helps.=
=20
Any help/recommendations would be recommended. I am terrifically frustrat=
ed
and feeling quite powerless -- and don't want to give up breastfeeding.=20=
Thank you so much,=20
Beth
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------------------------------
Date: Sun, 10 May 2009 12:01:06 +1000
From: Karleen Gribble <[log in to unmask]>
Subject: A watershed for Australia
We are finally going to have a universal (well except for very high =
income earners) paid maternity leave scheme. 18 weeks, which is not as =
good as it could be but still very exciting!
A wonderful thing for Australian mums
Karleen Gribble
Australia
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------------------------------
End of LACTNET Digest - 8 May 2009 to 9 May 2009 (#2009-502)
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