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Rachel e-mail <[log in to unmask]>
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Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 23 Mar 2000 17:00:50 +0100
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We have the dubious distinction here in Norway of having very high rates of smoking in pregnancy (up to 40%, yuck) and while breastfeeding, and we have also documented a tendency for smokers to wean earlier than non-smokers, possibly due to the effects of smoking on BF hormones, making it more actual work to BF.
When I talk to new mothers, which is 90% of what I do at work, I make clear that I do not condone smoking or belittle the threat to health which it represents.  I also make it clear that my antipathy for smoking does not extend to the smoker.
The latest info on BF, smoking and SIDS is that artificial feeding and smoking gives babies the highest risk of dying of SIDS, and BF and not smoking gives the lowest (from a seminar I was at, and no, I don't have the references, DRAT).  Non-smokers who feed artificially are at slightly higher risk, and smokers who BF are a good bit higher than that again, but still significantly lower than smokers who don't BF.  I give women all this information as unemotionally as it is possible to talk to a post partum woman about her baby's risk of dying.  But the main thing I try to get across is that their own milk is best for the baby, and we encourage women to postpone their smoking until just after a feed, in hopes of a long interval between smoking and next feed.  We also offer all kinds of support for quitting smoking, with not great success.  Women are used to being scolded and shamed for smoking, and they are used to feeling guilty.  I don't know of one study that shows lots of desired behavioral changes from increasing guilt feelings, so I try to avoid that tack.  This does not mean I mince words.  I assure you, I do not.  I also mention in so many words the increased likelihood of surviving to see the baby to parenthood if one doesn't smoke.  By telling a woman that BF offers a chance of mitigating to some degree the very negative effects of smoking, and that BF has an even stronger positive effect in babies of smokers because of the disadvantage these babies have to begin with, I find they are quite open about their nicotine habits.  I assume women have a genuine desire to do the best by their babies and am rarely disappointed.  I just wish their desire to do the best by themselves were strong enough to get them through quitting smoking!  My hope is that if they remember that the BF specialist didn't judge them, and respected them enough to give straight information, their general emotional tone toward BF will be affected positively.  This is an area where the half-filled glass analogy is a survival necessity; optimism is everything!
I am of course aware that new knowledge is being produced all the time, and that the information I give today will probably not be the same as what I say in five years' or even five months' time.  That is all part of being alive.
Rachel Myr
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Kristiansand, Norway, where days are now longer than nights, crocuses are blooming and daffodils and tulips not far off.  Yea SPRING!

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