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Subject:
From:
Christine Betzold <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 30 May 1999 20:32:16 EDT
Content-Type:
text/plain
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        The May 25, 1999, edition of "The Clinical Advisor" addressed two
questions on breastfeeding.  Responses to both the questions with the
subjects "When infants don't regain birth weight," and "Breastfeeding and
Hepatitis B," are uniformed and confusing.  Some highlights:

        Ms. Waldrop starts by answering the weight gain question quite well
and should be commended for following AAP guidelines.  She recommends
observation of the mother/child nursing dyad.  However, she then falters.
Other than talking about correcting of mechanical problems she makes no
mention of how to correct them or other methods of increasing milk transfer.
Moreover, she does not give information about how to give the supplement  in
the case of the dehydrated infant.
          Ms. Waldrop make the comment that, " If the infant appears at all
dehydrated, his or her risk for electrolyte imbalance outweighs any desire on
the part of the mother to breastfeed."  Moreover, she does not give
information about how to give the supplement in the case of the dehydrated
infant.

The next question regarding hep B and bf starts by quoting the Redbook of the
AAP 's stance on hepatitis B and then goes on to say:
 Dr. Ryan states,..." Certainly, mothers in developing countries where
formula is not available should breast-feed.  In the United states, a mother
who strongly desires to breastfeed her infant can probably do so with minimal
or no risk. " ...
And Dr. Mishell states,... "However, if there is any chance that a
potentially fatal disease could be transmitted to the infant by
breast-feeding, no matter how uncommon this occurrence, I would recommend
that a woman with hepatitis B utilize another source of providing nutrition
to her infant."
I spent two hours writing an e-mail to this journal,  if any would like to
further comment their e-mail address is [log in to unmask]  This is free
monthly journal for  NP's that I receive.

 Sincerely,
 Christine Betzold  FNP, MSN, CLE

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