I would like to second some of Tina Smilley's comments. The article in
Birth (printed in March 1990) was followed by a lengthy letter from me
(actually they prublished only abont 1/3 of what I wrote due to space
limitations) and a replay from the authors.

Something elese not mentioned, but something many LCs I knokw in Denver
area (1 mile above sea level) is that babies do not always grow quite the
same way (generally somewhat slower, tho probably not staititcally
significantly differnet) than babies at lower altitutdes. We know that bili
levels are higher there and in very high altitutdes (Peru, for example)
those babies are much smaller!  This is not considered in the reate of
early growth by the authors.

The BIrth article does distinguish between areolar and non-areolar surgey
and shows that the former fwere less likley to have sufficient milk.  But
some in both groups did, so the picture is not entirely clearcut.

The point about time to develop decent milk supply is a good one. How many
of these babies were exposed to maternal analgesia/anesthesia? If they
were, which ones were in the insufficient group? Might epidural effects
(known to last up to 5 days) be implicated in the wieght loss gropu at day
5?

Tina Smillie's post and this one just go to show that we all need to look
VERY CAREFULLY at studies and see what we might learn from them, and how we
might improve on them should we redo the study.  (the apex of good science
is not easily attained!)



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 %% "We are all faced with a series of great opportunities      %%
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 %% definition of a lactation consulting service.               %%
 %% Kathleen G. Auerbach,PhD, IBCLC - [log in to unmask]          %%
 %% Homewood, Illinois USA                                      %%

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