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Subject:
From:
"Kristi Downs BSN, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 27 Jan 2015 12:27:56 -0500
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Hello everyone,

Looking for guidance on where to find information and how to present this information to a couple of physicians with whom I work.  Here are the challenges:

1. A physician stated that moms on calcium channel blockers cannot provide pumped milk nor breastfeed based on a subset of breastfeeding recommendations from the AAP.  I have not been able to locate this subset.  

The physician and I have access to the lactmed app, Dr. Hale's website, app, and M&MM.  I am aware that mothers are prescribed calcium channel blockers and breastfeed.  I think this physician's concern is primarily extremely premature infants receiving milk from mothers on calcium channel blockers.

2.  A physician did not want a mother to provide hind milk/concentrated fat milk. The infant diet was fortified whole breast milk.  The physician concern:  if high fat milk is fortified, then the osmolality would be too high and potentially cause a higher risk for NEC.  

My understanding is that lactose is the main regulator of osmolality and that osmolality is related to mineral and CHO content.  

I prefer to provide evidence/research to physicians when they have concerns surrounding lactation or are not up to date in their knowledge base.  All the team members need to be on the same page when providing information to lactating moms.

Thanks in advance,

Kristi

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