This past week my hospital participated in a live teleconference with
Dr. Ruth Lawrence and Dr. Mary Applegate of the NYS DOH.  Although two
neonatologists attended, there was not one pediatrician who came, despite
personal invitations from us.  Very disappointing turnout.

     I wanted to highlight some points made by Dr. Lawrence.

     She seemed to favor the scissor hold of the breast, because in the
C-position, the mother may press too hard with her thumb, resulting in the
nipple being aimed upward.  Also, the thumb tends to cover the lower areola.
 She said the scissor hold is more "natural" and instinctive for mom.

     She said that drugs such as Nubain and Demerol used for labor pain may
pose a problem for infant's suck if given in two hours before birth, but
probably not after 4 hours before birth.

     She said that a Rochester study showed that there was no difference in
infant feeding if the mother received an epidural.  This was a blind study
with 200 patients.  All infants were scored every day while in hospital.  She
admitted she was startled at the results and mentioned that the study did not
look at length of  the epidural nor if multiple doses were given.  When the
researchers went back to look at these, they did not have enough numbers to
examine it.

     Dr. Lawrence said that BF babies under one month of age must stool every
day, in fact, a minimum of three times per day.

     She said that she believes that nipple confusion does exist and
explained the differences in suck physiology.

     The NYS DOH will be initiating learning activities for grades K-12 to
help BF become the expected standard.

     Babies fully BF do not need supplemental vitamins with the exception of
dark skinned babies and babies with absolutely no sunlight exposure.  Also,
the mother should know if her water supply is fluoridated.  If it is not, the
pediatrician should prescribe fluoride for the mother, not the baby.  No need
to supplement iron.  She recommends a low iron formula if  necessary, since
lactoferrin absorbs iron and E-Coli thrives on iron.

     Mother can BF with Lyme's disease if she has been treated for 24 hours
worth of medication.


     I'm somewhat behind in my digests, so apologies if someone posted this
earlier.  We still have a few pedis that want their BF moms to time their
feeds and one even gives moms instructions on how to boil water then add
sugar to it and feed to baby inbetween BF!  My jaw is still dragging on the
floor from sneaking a peek at her instuction sheet that she hands moms.  We
can change in-hospital policy all we want, but the mom will always say, "But
the doctor said......".

                           Thanks,
                           Stacey Richards RNC, IBCLC
                           NYC, NY