Hi Kathleen,

I'm back - got Torrey off to Florida with over 100 other teenagers - ought to
be an interesting trip for the bus drivers - 24 hours!!  Re:  Pierre Robin -
feedings, for the most part, depend entirely upon the severity of the
syndrome and the malformation of the jaw, palate, etc.  The biggest danger is
that the baby won't be able to breathe based on the malformation, the
receding jaw and the placement of the tongue.  IF the baby can latch on to
the breast and maintain suction AND can breathe adequately, then
breastfeeding can be accomplished, but will need an SNS,   If not, and mom
can pump, try the Haberman with the small, short nipple opened to the widest
spot. I think baby has to be fed in an upright position at all times.  I'm
sure someone else has more information on it that I do.... I honestly have
never worked with one myself.  I'll check with Linda Kutner and see what
she's done - I think she's had a couple.

Re:  Prozac - again:  I talked to Bob, and he said that the problem is more a
lack of hard data re the true effect of Prozac on the baby when mom is
breastfeeding.  Its been around long enough, and most of the reports have
stated there doesn't seem to be any effect, although you will get the
occasional report of a baby that is more colicky.  The literature generally
shows an absence of clinical problem, though it is a theoretical problem.
 I'd love to see what they are doing in other countries.  Pat Lewis -- do you
know what the standards on Prozac are in Australia?  Since there are no
restrictions on using Flagyl with nursing moms in Australia (see Ron
Batagol's book), but there are here, I would like to know what the perception
is on something like Prozac.  Do they even use it?

The AAP recommends using it with caution.  Any other comments?

Jan