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From:
Karleen Gribble <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 9 Sep 2005 11:04:24 +1000
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A couple of days ago someone posted that preparing for the next emergency that relactation (and infant feeding in emergency situations in general ) is something that they should look at educating themselves about now. I'd like to support this suggestion.

My experience as someone who speaks pretty regularly about relactation to different groups including to students preparing to sit the IBCLE, lay counsellors and practicing lactation consultants is that many have thought of relactation as something that is a rare situation, something that they are not likely to need to know about or will use in their practice and for this reason many are quite disinterested in it. My opinion is that to a degree, this is chicken and egg stuff, lactation consultants/lay counsellors who are scared by relactation (and a lot are!) do not provide an environment in which they will find many situations where relactation will be something that mothers pursue. However, in situations where lactation consultants or lay counsellors do feel confident about the process of relactation they may find that it is something that they use with mothers on a semi-regular basis. I've seen this happen with some LCs local to my area, just because they've heard me talk about it ad infinitum! When I speak on the topic of relactation at conferences etc what I say is that the only LC or lay counsellor who does not need to know about relactation is the one who does not come across any women who have prematurely weaned their baby.....ie there is no one.  Having seen lots of different women from lots of different situations successfully relactate I can also say that you never can tell just who will be interested in relactation and who will not and so mentioning the possibility to every mother is therefore appropriate. 

For those looking for a source of info on relactation you cannot go past the WHO booklet, many breastfeeding textbooks have deficiencies in this area and are not necessarily sources of accurate information on this topic but since the WHO booklet is downloadable for free everyone should have a copy! http://www.who.int/child-adolescent-health/New_Publications/NUTRITION/WHO_CHS_CAH_98_14.pdf

For those specifically looking at infant feeding in emergencies the Emergency Nutrition Network Models are just fabulous http://www.ennonline.net/ife/index.html

In addition I would also suggest that people get a hold of the following paper (if you can't access it I have a copy I might be able to send) which discusses one approach that is supportive of breastfeeding and works with very ill little babies who are not strong enough to increase mum's milk supply...it basically describes use of a breastfeeding supplementer in this situation.

Golden BE, Corbett M, McBurney R, Golden MH. Current issues in tropical paediatric infectious diseases. Malnutrition: trials and triumphs. Transactions of the Royal Society of Tropical Medicine and Hygiene 2000; 94: 12-13.

I guess what I am saying is that if LCs and lay counsellors become educated about relactation, not only might they be of use in emergency situations they might find that this is a tool that they use regularly in their work. Not only this, if women are told about the possibility of relactation, they may find a use for it themselves. I wonder if there were situations in New Orleans where mothers who had babies a few weeks old who knew about relactation and so were able to do it on their own. I wonder if there were mothers who would have done it had an LC or someone else told them as they left the hospital bottlefeeding that they could start breastfeeding again and that they could start to make milk even after drying up just by putting baby to the breast....maybe each mother should be sent home with information on relactation just in case....only slightly tongue in cheek here!

Karleen Gribble
Australia

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