part 2 human milk reducing infections
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--l-JE-6lKNHfxj2iElvG,:el0Jy,mhtrrIvtGl/dRlNcT-6NsFkY9y1Rq,hS)hOOUMWY:hY--
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Date: Wed, 25 Jan 2006 21:30:52 EST
Reply-To: Lactation Information and Discussion
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From: Ann Conlon-Smith <[log in to unmask]>
Subject: Best video
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I know this question has been asked before, but times change as does media.
What is your favorite breastfeeding video to show to a fairly uncommitted
crowd, say as in a Babies R Us seminar? They have no projector, so I cannot
use my Power Point presentation. They have no DVD player, just VHS. Thank
you, Ann Conlon-Smith
Ann Conlon-Smith, IBCLC Triangle Lactation Consultants
_www.trianglelactation.com_ (http://www.trianglelactation.com/)
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Date: Wed, 25 Jan 2006 22:00:09 -0700
Reply-To: Lactation Information and Discussion
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From: Phyllis Adamson <[log in to unmask]>
Subject: Re: Best video
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The Real Deal on Breastfeeding
Available from www.realdealvideos.com
The VHS is appr. $25 and runs about 25 minutes
"Real women sharing real stories" and done by Heather Kelly, IBCLC,
factual info from Alicia Dermer, MD, and real women telling their own
stories.
Copyright 2004.
I have no financial interest other than I own a copy and I like it.
Phyllis Adamson, IBCLC, RLC
Glendale, AZ
[log in to unmask]
> I know this question has been asked before, but times change as does
media.
> What is your favorite breastfeeding video to show to a fairly
uncommitted
> crowd, say as in a Babies R Us seminar? They have no projector, so I
cannot
> use my Power Point presentation. They have no DVD player, just VHS.
Thank
> you, Ann Conlon-Smith
>
> Ann Conlon-Smith, IBCLC Triangle Lactation Consultants
> _www.trianglelactation.com_ (http://www.trianglelactation.com/)
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Date: Thu, 26 Jan 2006 00:30:51 -0500
Reply-To: Lactation Information and Discussion
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From: "Jennifer Tow, IBCLC" <[log in to unmask]>
Subject: Re: LACTNET Digest -apple cider vinegar
In-Reply-To: <[log in to unmask]>
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Jean,
I sometimes have moms use apple cider vinegar topically when they have
all the predisposing conditions for thrush, but no symptoms, especially
if they have a significant history. As to internal use--ACV is used to
alkilinize and detoxify the body.
ACV is used by organic farmers to prevent mastitis and I have read of
it being recommended by midwives for mastitis. It is used by many
people as a daily tonic to keep the body alkaline and the immune system
strong. I do not know the whole history or who suggested it, but ACV is
not a bad idea. The only concern is that ACV should be very diluted so
that it does not damage teeth.
Jennifer Tow, IBCLC, CT, USA
"Date: Wed, 25 Jan 2006 12:00:35 -0500
From: "J M Westerlund-Rice, MPH, RD"
<[log in to unmask]>
Subject: vinegar for chronic mastitis??
Someone recommended that my client take 4-6 Teaspoons of apple cider
vinegar per day to prevent mastitis. This poor mom drinks it in apple
juice everyday. Has anyone heard of this? Any references would be
appreciated. Thank you.
Jean Westerlund-Rice, MPH. RD
Breastfeeding Specialist "
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Date: Wed, 25 Jan 2006 22:13:48 -0800
Reply-To: Lactation Information and Discussion
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From: Jeanette Panchula <[log in to unmask]>
Subject: Topics to cover for talk to MCH professionals
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I've been asked to create a presentation about breastfeeding to state
Maternal and Child Health staff - these are Masters level and PhD people who
work on the designs and plans of statewide programs: Nurses, Dietitians,
statisticians, etc. I have been offered 2 days (so I think in terms of 12 -
14 hours.). Some of those attending have been working on breastfeeding
projects, others are not involved in them at all, but do work on programs
such as Adolescent Family Life, Black Infant Health (pregnancy through 1 - 2
years), Comprehensive Perinatal (program covers pregnancy through 6 weeks)
Services Program, epidemiology, laboratory field services, Family
Planning....
...so I'm asking for some brainstorming here! Thoughts?
This will be a VOLUNTARY activity - so ideas on how to best market it would
also be appreciated!
Jeanette Panchula, BSW, RN, PHN, IBCLC
California
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Date: Thu, 26 Jan 2006 07:02:05 -0500
Reply-To: Lactation Information and Discussion
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From: "Linda J. Smith" <[log in to unmask]>
Organization: BFLRC
Subject: South Dakota lactation rooms
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Please pass this on to South Dakota residents.
This South Dakota state Senator is working on a great program!
-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]]
Sent: Monday, January 23, 2006 11:02 PM
To: [log in to unmask]
Subject: SD Lactation Rooms
To whom it may concern:
Please review SB 177 at http://legis.state.sd.us/sessions/2006/index.aspx
http://legis.state.sd.us/sessions/2006/bills/SB177p.pdf
Also see this article
http://argusleader.com/apps/pbcs.dll/article?AID=/20060123/NEWS/60123010.
If you have any representatives who would like to speak as a proponent of
this bill when it is before committee, that would be very helpful. If you
know of any other groups who would also like to support this legislation, I
would appreciate that as well. Thanks,
_Jason
Senator Jason M. Gant
PO Box 2012
Sioux Falls, SD 57101
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Date: Thu, 26 Jan 2006 23:13:33 +1100
Reply-To: Lactation Information and Discussion
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From: Karleen Gribble <[log in to unmask]>
Subject: Australia Day award
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Today is Australia Day and in the honours list is Mary Paton one of the =
founders of the Australian Breastfeeding Association
Some of the ABA press release is below.
Mary's award for today was an upgrade from an OAM (Medal of the Order of =
Australia) to an AM (Member in the General Divison).
Karleen Gribble (who had 2 grandparents with an OAM)
Australia
Australian Day Honours for Breastfeeding Guru=20
Mary Paton visionary and founder of the Nursing Mothers Association of =
Australia (now known as the Australian Breastfeeding Association) has =
her OAM status upgraded to an AM today, Australia Day 2006. In =
recognition of Mary's ongoing commitment to breastfeeding mothers across =
the nation, her vision and purpose, it is fitting that Australia honours =
Mary and the association that she created over 40 years ago. Mary Paton =
said today "I'm delighted to receive the award. It helps to put the =
association on the map." Mary Paton stands out from others because she =
had the vision, integrity and drive to start an influential and =
far-reaching voluntary organisation dedicated to helping women =
breastfeed in an era where the word breastfeeding could not even be used =
in public. "This award enables the association to be recognised for its =
incredible work and all the thousands and thousands of volunteers who =
have been part of it over the years." Mary continued. The association's =
volunteers and members join Australia in honouring Mary on Australia Day =
2006, who without her vision and dream may not have been able to teach =
the art of breastfeeding and work toward influencing our Australian =
society to acknowledge breastfeeding as the norm for infant nutrition. =
ABA President Margaret Grove congratulated Mary and said "Mary has been =
actively involved in NMAA (now the Australian Breastfeeding Association) =
at all levels for 40 years and her attendance at ABA events is actively =
sought."
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Date: Thu, 26 Jan 2006 07:33:59 -0500
Reply-To: Lactation Information and Discussion
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From: Dawn Kersula <[log in to unmask]>
Subject: Rooming-in v mother-baby care
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We changed to what Celeste Phillips (AWHONN literature) calls =
"mother-baby care" for postpartum, and I much prefer that wording to =
"rooming in". Mother-baby care implies - and has become in fact, here! - =
that the nurse nurtures and "nurses" both mother and baby. We do good =
assessments on babies and help mothers blossom into themselves as moms. =
That may mean occasional "grandma service" while mom is in the shower =
(or while they go out for a cigarette - but that's a topic for another =
day!). But under the best of circumstances it also means helping mom =
learn early feeding cues, helping her hold the baby a lot, good help =
with feeds (no matter what kind they are), and truly learning what this =
mom needs to be able to go home whole.
=20
And I guess for me the Rolls Royce of hospitals would have a fireplace =
and mother-baby care both...(oh no, here I am going home again!).
=20
Dawn M. Kersula MA, RN, IBCLC
The Birthing Center at BMH
17 Belmont Avenue
Brattleboro, VT 05301
802-257-8278
[log in to unmask]
=20
=20
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Date: Thu, 26 Jan 2006 08:50:20 -0500
Reply-To: Lactation Information and Discussion
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From: "Betsy Riedel,RNC,IBCLC" <[log in to unmask]>
Subject: good videos
I do the Babies R Us mini seminars every couple of months at our local
store and have been doing so for about 2 years now. I do not show a video
at all. I take some of my visuals (flip chart stuff), but I present about
a 30 minute mini version of my regular hospital based 3 hour breastfeeding
class. I tell the people right up front that my presentation is meant to
be a "teaser" and that they should go to a real, full-length breastfeeding
class of their choosing. Personally, I get really good feedback from my
seminars and I put very little effort into them.
Betsy Riedel RNC
IBCLC
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Date: Thu, 26 Jan 2006 10:15:12 -0500
Reply-To: Lactation Information and Discussion
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From: Gena Henderson <[log in to unmask]>
Subject: Breastfeeding videos
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The Breastfeeding Why-To, How-To videos are good ones. They're by Vida Health Communications, Inc. and are presented by AWHONN too. I don't have any stake in them, I just show them sometimes to my more uninterested audiences when I can't seem to get a conversation going. ;)
Gena Henderson
WIC peer counselor
SC DHEC
> Date: Wed, 25 Jan 2006 21:30:52 EST
> From: Ann Conlon-Smith <[log in to unmask]>
> Subject: Best video
>
> I know this question has been asked before, but times change as does media.
> What is your favorite breastfeeding video to show to a fairly uncommitted
> crowd, say as in a Babies R Us seminar? They have no projector, so I cannot
> use my Power Point presentation. They have no DVD player, just VHS. Thank
> you, Ann Conlon-Smith
>
> Ann Conlon-Smith, IBCLC Triangle Lactation Consultants
> _www.trianglelactation.com_ (http://www.trianglelactation.com/)
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Date: Thu, 26 Jan 2006 10:31:01 -0500
Reply-To: Lactation Information and Discussion
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From: "Catherine Watson Genna, IBCLC" <[log in to unmask]>
Subject: Re: Topics to cover for talk to MCH professionals
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Oooh, Jeanette, what an opportunity.
What are the "take home" messages you want to give? Breastfeeding is
very important, the public health system is important in supporting or
undermining bf, babies are more capable than we ever thought,
maternal-infant togetherness is a key to infant capability. You can
share Nils' Bergman's research, show a snippet from Delivery Self
Attachment, and share some of the important statistics from the studies
that show that failure to breastfeed increases diabetes, some cancers,
heart disease susceptibility, asthma, etc, etc. You can talk briefly
about mechanisms, that will make folks with advanced degrees intrigued
and want to think about this further. Figure out which chronic diseases
are of greatest concern to your public health folks, and focus on those.
After all, breastfeeding is primary prevention for most of our public
health nightmares. And I'd make sure that Anna Coutsoudis' work was in
there somewhere too (exclusive bf reduces maternal to child transfer of
HIV, for the newbies here). And of course try to reframe the debate
about "maternal choice" that the artificial milk manufacturers have set
up to "health decisions and behaviors", which is what it truly is.
Catherine Watson Genna, IBCLC NYC
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Date: Thu, 26 Jan 2006 10:48:34 -0500
Reply-To: Lactation Information and Discussion
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From: Nancy Wiand <[log in to unmask]>
Subject: Staff Nurse Competency in Lactation Management
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My hat is off to the lactation consultants and the Massachusetts
Breastfeeding Coalition who worked to get formula discharge bags out of
hospitals and to get the Revised Massachusetts Hospital Licensure
Regulations in place! Great job!
I wonder if any of you have a competency check list you use in hospitals
for staff nurse competency in initiating lactation management and handling
early breastfeeding problems. If so, would you be willing to share it with
me? You can send it to my email or address below.
Nancy Wiand, MSN, CNS, RN, FACCE, IBCLC
Women's & Family Health Services
Robinson Memorial Hospital
6847 N. Chestnut Street
Ravenna, OH 44266-1204
Phone: (330)297-8485
Fax # (330)297-8448
E-mail: [log in to unmask]
Robinson Memorial Hospital - Recognized as One of the Best Places to Work in Northeast Ohio.
Robinson Memorial Hospital - Excellent Healthcare Where You Need It
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Date: Thu, 26 Jan 2006 11:24:02 EST
Reply-To: Lactation Information and Discussion
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Subject: Babies R Us
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I have also done these seminars at Babies R Us. Flip charts work really
well. Bring a pretend life size doll for positioning explanation. I also explain
that it is best to attend a few LLL meetings or a breastfeeding class before
the baby arrives. There are usually dads at these seminar. It is always
interesting to here some of their questions. I do not think these events would be
long enough for a movie. Some people learn better by discussing breastfeeding
information and actually practicing with a doll than just watching a visual.
I think there is a saying about this somewhere.
Annette Leibovitz
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Date: Thu, 26 Jan 2006 11:55:08 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Topics to cover for talk to MCH professionals
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Try to show them that they don't have to know it all, just where to find it.
Create a resource list that includes the major "good" books, the LLLI CBI,
etc. Maybe you can index it into journals to subscribe to, reference books,
patient education resources, professional resources ( like the CBI and LLLI
Professional liason department), and websites. Also include an explanation of
our alphabet soup-or Who's who in Breastfeeding. ILCA's Guide to Breastfeeding
Management in the First 14 Days tells all ( and why) in an easy to use
format. Maybe you can give them that as an handout.
When I do a presentation for HCPs, I like to put my handouts in a separate
folder from the other conference handouts, and label that so they can easily
find their breastfeeding notes.
Other important notes I think they need to know about:
Optimizing the opportunities for mothers milk when mothers and babies have
to be separated
Evaluating the use of birth control methods in a breastfeeding mother
Debunking myths
Evaluating a breastfeeding's baby's growth and development
How the breasts work ( or as I like to say-"they're not faucets that you
just turn on and off")
Good luck.
Barbara Whitehead, BS, IBCLC, RLC
eastern NC
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Date: Thu, 26 Jan 2006 12:16:26 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Re: LACTNET Digest - 25 Jan 2006 - Special issue (#2006-82)
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In a message dated 1/25/2006 6:00:03 PM Pacific Standard Time,
[log in to unmask] writes:
Protecting Infants through Human Milk : Advancing the Scientific
Evidence (Advances in Experimental Medicine and Biology)
by Larry K. Pickering
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
This is the compilation of the papers presented at the ISRHML (International
Society for Research in Human Milk and Lactation) meeting Oct 2002. It is
superb and geared toward physicians and researchers in the field of human
lactation.
Nancy
Nancy E. Wight MD, IBCLC, FABM, FAAP
Neonatologist
Medical Director, Lactation Services
Sharp Mary Birch Hospital for Women
San Diego, CA USA
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Date: Thu, 26 Jan 2006 12:21:20 -0500
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From: Karen Koss <[log in to unmask]>
Subject: Topics for MPH Professionals
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Jeanette
The hook is "What's in it for them."
I suggest that you challenge the various departments to come and hear why
the topic of breastfeeding relates to their particular focus. Prepare to be
able to address each department that will be attending as well as those who
do not, as word will spread from those who were in attendance. Share
resources that are available to help them when they have questions. Offer
opportunities for them to brainstorm ways that their departments can
collaborate with each other and ways they can institutionalize breastfeeding
into their messages. Many departments have just never thought about it.
Laurence Grummer-Strawn made a great statement at the United State
Breastfeeding Committee meeting this past weekend.
"Breastfeeding has to connect with all that we do in health."
I look forward to hearing all the other suggestions that you receive.
Good luck.
Karen Koss
Michigan, USA
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Date: Thu, 26 Jan 2006 11:51:41 -0600
Reply-To: Lactation Information and Discussion
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From: Amy <[log in to unmask]>
Subject: Re: Babies R Us
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beware, they hand out a noncode compliant goodie bag at the end. I did this
twice last summer for breastfeeding week they asked me in advance for what to
put on a display table for my talk, the items I chose really helped work as
props for my talk, the mothers and fathers all sat in a row of those
recliners,
I would point out that you can BF anywhere and don't need to do it only
in those
"glider" chairs, I brought a stack of the LLLI/ 4women.gov color booklet its a
great booklet and you can get an unlimited amount from www.4women.gov
for FREE!
My favorite videos are the clips on www.breastfeeding.com, they are very breif
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Date: Thu, 26 Jan 2006 13:18:41 EST
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From: [log in to unmask]
Subject: Taking a break from LC work
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After 30+ years in MCH, and recently sending in all the materials (!) and
money (!) for IBCLC recertification, (15 years), I am taking a break from
hospital LC work. The service at the hospital has expanded greatly in the past few
years and is well staffed, I left the weeky Bf moms group in good hands.
Needing a change of scenery I took a PRN job a short 12 minute commute from
my home, in Occupational Health, ...same pay
The health care system I work for did a very good job retaining me by
helping me find a job within the system that met my criteria: something different
and interesting, no weekends, evenings, or holidays, closer to home.
This new job also happens to have no hospital committees, ....no worry about
mothers and babies, ...no annoyance about parents making bad feeding
decisions in spite of copious "customer service excellence focused" lactation
service efforts and support, ...no guilt over not working extra hours and days,
..no car-jammed commute, no parking problems, no staying late to see just a
couple more desperate pts or to respond to desperate staff. None of the other
intense, stressful, hospital-based issues.
Just needed a break from all that.
I have a feeling that other LCs have been through this phase.
Correct?
Debbie Tobin
RN BSN IBCLC LCCE
_www.BestBreastfeeding.info_ (http://www.BestBreastfeeding.info)
Fairfax County, Virginia suburbs outside the Washington DC beltway
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Date: Thu, 26 Jan 2006 13:18:48 EST
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I would like to find a MPH program, and one that I could tailor to include a
lactation focus at some point.
I do not need a MPH for my current job or for the foreseeable future, happy
doing PRN, but would enjoy an MPH program/education, and ya never know what
may strike my fancy next year.
The local more affordable university (GMU) does not have an MPH program,
..GW in DC does, as does Johns Hopkins, but, both would cost close to or over
$40,000 for the degree. Too much for education not required but that I would
like to have.
Online graduate programs seem to be booming by leaps and bounds, many
options, several MPH programs, ranging from ~$14,000-$36,000 for the degree, so,
several more affordable options and pretty much the same curriculum for
programs on campus or online.
Are online graduate programs becoming more accepted by people who hire
graduate prepared nurses?
If you have an opinion about online graduate programs in general, or MPH
programs in general, or MPH programs that might be more suited to a lactation
focus at some point, please let me know.
TIA,
Debbie Tobin
RN BSN IBCLC LCCE
_www.BestBreastfeeding.info_ (http://www.bestbreastfeeding.info/)
Fairfax County, Virginia suburbs outside the Washington DC beltway
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Date: Thu, 26 Jan 2006 13:41:09 -0500
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From: "Micky Jones, LLL Leader,CLE, CHBE, CLD" <[log in to unmask]>
Subject: Babies R Us - Goodie Bags
I teach a free breastfeeding class at the Babies R Us in Nashville, every
other month (they have requested that frequency because of the popularity of
the class). I have been through several "promotions managers" or whatever
they are called. The current woman is EXCELLENT and breastfed her own
children and fully supports the class.
I have always stipulated that they take out any formula ads, pacifier
samples, etc out of the bags before I get there. I then also check the bags
when I arrive. My perspective is, If they don't like it they can find
someone else to teach the class. I have never had a word of protest AT ALL
from them. I actually speak out about "cheap" pumps too, by name. That is
fine with them because they sell more PIS that way (But I make it very clear
that pumps are not necessary to breastfeed).
It has been up and down but my class size ranges from 6-8 people to 20
people or more. Usually 2-4 dads, even some grandmas and friends. ALOT more
response than my LLL group and fee based classes I have tried to do. I
consider it public service and part of my own personal mission. I do hand
out flyers for my personal business so I do get advertisement out of it.
I would agree that showing a video wouldn't be the best use of time. I do a
very basic class but cover alot. If you would like my basic outline, I would
be happy to share. Email me privately at [log in to unmask]
Blessings,
micky
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Date: Thu, 26 Jan 2006 14:03:16 -0500
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From: Shandell Ferguson <[log in to unmask]>
Subject: Part 1 Human milk reducing infections
Hello! My name is Shandell Ferguson, and I am a junior in the nursing
program at the University of North Dakota. I am enrolled in a
childbearing class, and am currently in my OB clinical rotation right
now. I joined this listserv to learn about various topics. This past
week I have been reading the archives and have found some of them to be
very interesting. OB is a fairly new subject for me that I have not had
much experience with or know much about. I am very eager to learn and I
hope to have a great time learning all about babies and their mom.
While I was looking through some topics about breastfeeding, one
specific topic caught my eye. This topic is: does human milk help
reduce infection rates in infants (preterm or low birth weight) versus
formula fed infants (preterm or low birth weight). I did some
research in this area, and came up with some interesting facts.
According to Raisler, Alexander and O'Campo (1999), babies that are only
breastfed had the lowest illness rates including diarrhea, cough or
wheeze and ear infections. Also their results showed that babies who
had some breast milk but mostly formula had no protection.
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Date: Thu, 26 Jan 2006 14:04:38 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Shandell Ferguson <[log in to unmask]>
Subject: part 2 human milk reducing infections
Another study conducted by Schanler and Atkinson (1999),
suggests that human milk may not have all of the nutrients a preterm
baby may need. They found that human milk is the best for the preterm
infant over formula fed infants. However, appropriate nutrient
fortification should be implemented into the preterm's diet. The
authors state that infants fed fortified
breastmilk containing IgA have shorter hospitalizations compared
with formula fed infants.
Silva, Jones and Spencer (2004) conducted a study in preterm
infants comparing breastfed to formula fed infants and measured sepsis
as their main outcome in both groups. They state in their
article that they have sound evidence that breastfed premature infants
and low birth weight infants have protection from human milk. However,
there were flaws in this study that included poor study design and
inadequate sample sizes.
My question to you is what are your experiences with lower rates of
infection in preterm infants who are breast-fed. Also, should this
aspect of breastfeeding be promoted more toward mothers of infants and
their families.
Thank you,
Shandell Ferguson SN
Raisler, J., Alexander, C., O'Campo, P. (1999,January).
Breast-feeding and infant illness: A dose-response
relationship?
American Journal of Public Health, 89, 25-31
Schanler, R. J., Atkinson, S. A. (1999). Effects of Nutrients in
Human
Milk on the Recipient Premature Infant. Journal of Mammary
Gland Biology and Neoplasia, 4, 297-307
Silvia, A. De, Jones, P.W., Spencer, S.A. (2004,May). Does human
milk reduce Infection rates in preterm infants? Arch Dis Child
FetalNeonatal, 89:F509-F513. 509-513
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Date: Thu, 26 Jan 2006 12:30:15 -0800
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From: "Vicki.Ryan" <[log in to unmask]>
Subject: Re: prospective parents' expectations
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>Date: Wed, 25 Jan 2006 14:34:00 -0500
>From: Judy Campbell <[log in to unmask]>
>Subject: pampering
>When parents learn childbirth education from tv shows, and parenting,
>feeding etc from ads, and the
>birthplace is like a hotel, the whole thing adds up to crazy expectations
>that are so far off from reality, and so little empowerment, why would
>>anyone exclusively breastfeed????
ooooooooooohhhhhhhhh yeah, I have unfortunately been watching some bad TV in
these past couple weeks "off" from work, like A Baby Story and Bringing Home
Baby on The Learning Channel. Don't ask why, I'm getting ready to have #3!
plus I'm emotional and cry when the baby is born (and at most of the
commercials for dog food and household cleaning products too...except for
the Carnation Good Start one, for that one I throw the remote control at the
TV), I push when they push- bad for preterm labor ha ha...but mostly I rant
and fuss in disgust by what people must think is "normal" for childbirth and
feeding. I keep asking myself "why am I watching this crap?" Labor is
absolutely miserable until the epidural, everything is wonderful after
epidural, episiotomies and lying flat on your back pushing are normal,
vacuums are normal, the mom gets to view the "dirty" baby on a towel on her
gown on her chest for a second before he's whisked off to the warmer and
nursery for a few hours, pacifiers and bottle feeding are the
norm....parents say things like "I really like my sleep, my sleep at night
is really important to me, I hope (baby) learns that" and "Getting her on a
feeding schedule is really important to us"....a mom ignores her baby's
feeding cues (dad actually takes the screaming baby out for a long walk
around the block instead) until exactly 2pm to feed, then mom asks "what
time is it?" FOUR times during the first breast and then switches at exactly
2:20 even though the baby was settled in at a nice feeding....a dad says "I
really have mixed feelings about her (wife) breastfeeding," and describes
how he "wants to be involved" and how hard it is that he just gives the baby
to mom when he's crying and she nurses him and she's the only one who can
make him better.... even a mom whose husband is in the service deployed in
Cuba when she SROMs 3 weeks early and he's rushing to get there for the
delivery, the doc Pits the woman and says she'll "be happy with a cm an
hour" instead of letting her progress slowly and naturally and hopefully her
husband will arrive in time (he doesn't... then baby was in NICU for 8
days)....on and on...
forgive my ranting and probably getting off-topic, it's like when I read
Babywise, cussing and highlighting as I went, and my husband asked me why I
kept reading it if it made me so angry, I told him I have to know what I'm
up against ahead of time. it's sad to see what people "learn" from TV and
books. We've checked out alot of different prenatal books from the library
for our sons to see the illustrations of 'how big the baby is now' and 'what
he looks this week,' and some are downright awful in what they describe to
expect in childbirth and postpartum (am I allowed to name them? the one by a
pediatrician that says newborns won't be allowed to eat for 4 hours after
birth, they'll be in the nursery and get a bottle of water first, etc)
so now it's time for some *reality* TV, my 5 and 2 year old sons and I
are going to watch the videos of their births for the hundredth time (with
unmedicated very vocal mommy and her vagina, and then read Breasts by
Genichiro Yagyu for the hundredth time today and enjoy A Child is Born.
thanks for giving me a place to vent!
Vicki Hayes RN IBCLC, Lake Stevens WA (who is going to "just say no" to
bad TV, no matter how bad bedrest gets! ha ha, and whose 5-year-old Sean
offered to let me take his personalized *white* bathtowel to the hospital
"to wrap baby Lachlan in, I don't mind if he gets it bloody" --and his
dinosaur pillowcase, "I don't mind if you or Lachlan throw up on it.")
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Date: Thu, 26 Jan 2006 12:59:11 -0800
Reply-To: Lactation Information and Discussion
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From: "Vicki.Ryan" <[log in to unmask]>
Subject: "pacifier" in "for better or for worse" comic strip
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with my soy-latte-a-day habit, I got a kick out of this, but it reminded me
how plugging a baby's mouth with a pacifier when he's displaying feeding
cues is just a substitute, holding him off when he really wants the good
stuff (to nurse). Vicki Hayes RN IBCLC
http://fbofw.com/strip_fix/strips/2006/january/j4w/060126loc.gif
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Date: Thu, 26 Jan 2006 16:49:06 -0500
Reply-To: Lactation Information and Discussion
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From: Judy Campbell <[log in to unmask]>
Subject: hair salon workers/exposure to chemicals
I looked through the archives for information on beautician work and
breastfeeding/pumping at work, but I couldn't find anything. I thought this
had been discussed some time ago..It seems that the hair chemicals get
under the worker's nails, they breathe the fumes,etc., that there is alot
of exposure. A mother might be concerned that her milk would be
contaminated simply by touching her breasts after her hands have been
exposed to those chemicals. Are there warnings for pregnant women now? If
it's not safe during pregnancy, is it okay for pumping? thanks, Judy
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Date: Thu, 26 Jan 2006 18:53:12 -0500
Reply-To: Lactation Information and Discussion
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From: Stacy Brown <[log in to unmask]>
Subject: two maids
Hi everyone . Thank you for the welcome to Lactnet. I thought I was a
little more computer savy and it was brought to my attention that my
response to Tuesdays questions didn't get through, sorry about that. Here
I go again.
I am a childbirth educator and we also have a nurse on staff fulltime. Kim
and I have been involved for many years with a pregnancy center helping
women mainly in crisis pregnancy. It was with our heart for women there
that this business took a natural progression.
It is our intent to network within our community to bring support to women
not just exclusively dealing with breastfeeding.
Our donors are not compensated for their donations, however we do give
them a hospital grade breastpump free of charge regardless if they end up
qualifying to be donors. The milk that is donated is not used for research
for therapeutics for adult disease. Our expenses will be covered by
selling the milk to Prolacta for processing and then distribution to the
hospitals. Prolacta has a very comprehensive website that can answer more
indepth questions directly about them Our website is still under
construction. I appreciate the interest and welcome any additonal
questions. We are excited about the positive response we are already
receiving in the communiy.
Thank you
STacy Brown
Two Maids a Milking
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Date: Thu, 26 Jan 2006 18:57:38 -0500
Reply-To: Lactation Information and Discussion
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From: "Ellen Penchuk, IBCLC" <[log in to unmask]>
Subject: Great Editorial
This is terrific!!
http://english.ohmynews.com/ArticleView/article_view.asp?
menu=A11100&no=270919&rel_no=1&back_url=
Ellen Penchuk, IBCLC, RLC
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Date: Thu, 26 Jan 2006 19:20:39 -0500
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From: Naomi Bar-Yam <[log in to unmask]>
Subject: CNN article on sharing breast milk
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A friend sent me this URL for a CNN article on sharing breastmilk.
As sympathetic an article as I have seen in the popular media.
http://www.cnn.com/2006/HEALTH/parenting/01/26/btsc.cohen.breastmilk/
index.html
Naomi Bar-Yam
--------------------------------
Naomi Bar-Yam Ph.D.
[log in to unmask]
Researcher, Writer, Educator
in Maternal and Child Health
--------------------------------
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Date: Thu, 26 Jan 2006 20:38:43 -0500
Reply-To: Lactation Information and Discussion
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From: Debra Ray <[log in to unmask]>
Subject: CNN article
http://www.cnn.com/2006/HEALTH/parenting/01/26/btsc.cohen.breastmilk/index.html
Found this on CNN this evening. The article expresses concern about sharing
breastmilk - either expressed or from the source, but has some great
positive things to say as well. Deb Ray, RNC, IBCLC
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Date: Thu, 26 Jan 2006 20:44:36 -0500
Reply-To: Lactation Information and Discussion
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From: Kathleen Bruce <[log in to unmask]>
Subject: Two Maids
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Hi Stacy, thank you for your response. I have a question for you. I did a
bit of reading on the Prolacta website, as you suggested...and it says, in a
FAQ section:
" Q. Is it unethical to sell milk?
A. Traditionally, the milk banks that are members of HMBANA have always
charged money for the milk they provide. Whether it is referred to as a
"processing fee" or "selling milk", the end result is the same. HMBANA milk
banks charge for their milk and Prolacta Bioscience also charges for the
milk they process. Prolacta, however, does not sell to the public and its
products are designed only for use with very small, premature babies. "
My question is this....how can it be essentially the same, if mothers are
not compensated, but the end result is that milk is distributed on a
for-profit basis rather than a non-profit basis? These are two different
ways of doing business, it would seem to me. If a non profit milk bank
charges for its milk, to cover costs, there is no profit being made, other
than to cover expenses, so to speak. I don't understand how these end
results are "the same." I may not understand the full ramifications of how
milk banks are run..... And am no expert in the subject, so I welcome the
illumination and education.
For anyone who wishes to read more, the website FAQ section is at:
http://www.prolacta.com/faq.html.
As I was reading, I thought it was interesting to note that some overlap
exists in scientific advisors with HMBANA and Prolacta.
An interesting discussion. I think providing breastfeeding support to your
community is a wonderful thing, as long as it is provided by skilled
breastfeeding professionals. Do you have IBCLCs available to counsel and
support mothers who may come into contact with your facility? That would be
a good addition to the community you are serving.
Many thanks for the clarification. Have a great weekend.
Kathleen Bruce RN IBCLC
Kathleen Bruce RN IBCLC
Independent consultant:
Lactation Resources of Vermont, Medela, Inc. Listowner Lactnet listserv
[log in to unmask]
Archives: http://peach.ease.lsoft.com/archives/lactnet.html
On 1/26/06 6:53 PM, "Stacy Brown" <[log in to unmask]> wrote:
> Hi everyone . Thank you for the welcome to Lactnet. I thought I was a
> little more computer savy and it was brought to my attention that my
> response to Tuesdays questions didn't get through, sorry about that. Here
> I go again.
>
> I am a childbirth educator and we also have a nurse on staff fulltime. Kim
> and I have been involved for many years with a pregnancy center helping
> women mainly in crisis pregnancy. It was with our heart for women there
> that this business took a natural progression.
>
> It is our intent to network within our community to bring support to women
> not just exclusively dealing with breastfeeding.
>
> Our donors are not compensated for their donations, however we do give
> them a hospital grade breastpump free of charge regardless if they end up
> qualifying to be donors. The milk that is donated is not used for research
> for therapeutics for adult disease. Our expenses will be covered by
> selling the milk to Prolacta for processing and then distribution to the
> hospitals. Prolacta has a very comprehensive website that can answer more
> indepth questions directly about them Our website is still under
> construction. I appreciate the interest and welcome any additonal
> questions. We are excited about the positive response we are already
> receiving in the communiy.
>
> Thank you
> STacy Brown
> Two Maids a Milking
>
> ***********************************************
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Date: Thu, 26 Jan 2006 20:57:30 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Kathleen Bruce <[log in to unmask]>
Subject: Pumps
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One more question.... What type of pump is provided to the moms who will
donate milk? Just curious. Thanks! Do HMBANA milk banks provide mothers
with hospital grade pumps? I have no experience with this, as there is no
milk bank near to me.
Best regards,
Kathleen
Kathleen Bruce RN IBCLC
Independent consultant:
Lactation Resources of Vermont, Medela, Inc. Listowner Lactnet listserv
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Date: Thu, 26 Jan 2006 20:57:27 -0500
Reply-To: Lactation Information and Discussion
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From: "Betsy Riedel,RNC,IBCLC" <[log in to unmask]>
Subject: Babies R Us
When I speak at our local store (and have been doing so for a couple of
years now), they do NOT hand out any goodie bags at all: just some pretty
good literature). Thanks for all the extra tips, all of you.
As an aside, when I speak, I always ask them to turn off the public
address system so there is no music and no paging during my talk. It is
difficult enough to make oneself heard when you have to turn your head
from side to side to speak to all the people in those long rows of glider
rockers. Somehow, my groups always seem to be pretty big with probably 15-
30 people.
I also tell them that breastfeeding can be very successful without a pump.
Betsy Riedel RNC IBCLC
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Date: Thu, 26 Jan 2006 22:51:35 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Ann Conlon-Smith <[log in to unmask]>
Subject: Starting Solids and Breastfeeding
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Where can I find a study that reveals the importance of breastmilk as the
primary source of nutrtion, to be offered before complimentary foods in the
first year of life? I have searched the AAP pages but have not found anything
clearly related to this. I received a call tonight from a concerned mom of a
nine month old who is doing well, gaining weight appropriately and has met
appropriate milestones, which are impressive since he was a premie. He has
been happily breastfeeding all along and was started on solids at around 6
months. He eats a few times a day following breastfeeding. When the mom saw the
pediatrician today (one of my favorites and the one my own kids go to!), he
said that the baby should be eating way more solids, that they should be the
main source of his diet, that breastmilk was not as important anymore, should
not be offered until after the baby "eats a meal", and that the baby "could
not take in enough of this liquid to get calories"-- whatever on earth that
meant. If we were talking "water" then yes, that is true. Cows milk, rice
milk, soy milk - yep, I agree. BUT BREASTMILK??? This is not just liquid --
it is mega nutrition. So, what would be the best study or fact filled info
sheet I could send this doc? Thanks, Ann
Ann Conlon-Smith, IBCLC Triangle Lactation Consultants
_www.trianglelactation.com_ (http://www.trianglelactation.com/)
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Date: Thu, 26 Jan 2006 22:24:54 -0700
Reply-To: Lactation Information and Discussion
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From: "Margaret G. Bickmore" <[log in to unmask]>
Subject: Re: Starting Solids and Breastfeeding
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>Where can I find a study that reveals the importance of breastmilk as the
>primary source of nutrtion, to be offered before complimentary foods in the
>first year of life? I have searched the AAP pages but have not
>found anything
The WHO materials for World BF Week 2005, theme "Breastfeeding and
Family Foods", may be helpful. See
http://www.waba.org.my/wbw/wbw05/wbw2005.html and particularly the
action folder http://www.waba.org.my/wbw/wbw05/actionfolder.pdf
I do have one serious concern with the action folder. It makes the
statement, "On average, breastfed babies of 6-8 months obtain around
70% of their energy needs from breastmilk, this falls to around 55%
at 9-11 months, and 40% at 12-23 months."
It is tempting to read these numbers as "shoulds". BUT -- these
numbers are NOT recommendations, rather statements of what has been
determined to occur among breastfed babies in the US, and I believe
they reflect less-than-optimal breastfeeding practices. They come
from the following publication: Food and Nutrition Bulletin. 2003,
24 (1) Special
Issue Based on World Health Organization Expert Consultation On
Complementary Feeding.
http://www.who.int/mip/2003/other_documents/en/FNB_24-1_WHO.pdf
[warning: it's 144 pages] The percentages appear to be calculated
from the information in Table 2, which is on page 7 of the pdf. The
data came from a study in which mothers in the US breastfed their
babies exclusively for at least 4 months, then did whatever they
wanted with complementary foods. Certainly many if not most of these
mothers were influenced by the ubiquitous non-Code compliant
marketing practices of baby food companies in the US. The feeding
practices of this population cannot be used as a recommendation for
what breastfed babies SHOULD be doing.
Other than that little caveat, I have only praise for the WHO WBW
documents. They contain a lot of great information about the
particulars of feeding solids to breastfed babies, and are
well-referenced.
Warmly,
Margaret
Longmont, CO
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Date: Fri, 27 Jan 2006 00:37:08 EST
Reply-To: Lactation Information and Discussion
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From: Renee Drake <[log in to unmask]>
Subject: CNN ARTICLE
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In a message dated 1/26/2006 9:06:33 P.M. Pacific Standard Time,
[log in to unmask] writes:
http://www.cnn.com/2006/HEALTH/parenting/01/26/btsc.cohen.breastmilk/index.htm
l
As one of the moms who depended on milk from my friend, I have to chuckle at
this newscaster's wide eyed epiphany at "milk-sharing". For those who don't
know, my daughter Cate struggled to gain any weight from my milk alone
(because of post gastric bypass issues) but I wanted to avoid breastmilk
substitute by any means necessary. I was becoming increasingly worried that "formula"
may be the only answer for me, then a wonderful friend in my LLL group
volunteered to nurse my baby. (This was decided between us, LLL was not a factor
in the decision~disclaimer). My daughter gained weight, thrived and made it
through healthier and happier than if I were to give her ABM. Instead of
feeling ill at ease, I was comforted by her willingness to ensure the health of
my baby. Through this experience I found many women who "milk share" albeit
secretively. I remember telling an IBCLC friend what I was doing and she told
me how years ago as a nurse on OB, one of the docs was unable to nurse her
own baby so she would pump and supply the doc with milk to feed her baby. She
said it felt almost like a drug deal, they met in a closet and exchanged the
paper bag of EBM. LOL. No one ever knew. The same woman who I credit with
saving Cate's life also truly saved another baby. This particular baby was
an adopted child, born to meth addicted mother, and adopted by the aunt of
the birth mom. This child had problems with every known formula. She would
feed 4 oz and she would projectile vomit 3.5 oz of it easily. The poor babe
was LOSING weight and even the GI doc didn't know what else to do. My friend
and I looked at each other and both said, "She needs human milk". We told her
what we had been doing, being acquainted with my friend prior to this, she
felt she had nothing to lose so my friend began to pump for this baby. We all
cried as this baby drank 4 oz of her EBM and every bit of it stayed
down..not one bit spit up. Within a week, she had GAINED weight, and now the 4
girls, (my friend's twins, my daughter, and the other little girl) are all
playmates and are all roughly the same size. Happy and healthy. We joke that this
woman could literally breastfeed quadruplets. Though she doesn't want to be
jynxed lol. I have a lot of respect for milk sharing. I agree that you have
to be careful who you are getting your milk from. I wonder about perfect
strangers, if I were going that route, I would try and use a milk bank.
However, if it is my sister, my friend etc. I think I can judge by their
lifestyles how safe their milk is. I also find it difficult to believe that a drug
addict or someone using other risky behaviours are going to be breastfeeding
and donating anyway. Too much work, they have more "important" things on
their mind, if you know what I mean.
No one will ever convince me that milk sharing is wrong. My healthy happy
daughter is proof otherwise.
(http://www.snugglepie.com/)
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Date: Fri, 27 Jan 2006 21:32:28 +1000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Merewyn Janson <[log in to unmask]>
Subject: Re: CNN ARTICLE
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Renee Drake wrote:
>
>As one of the moms who depended on milk from my friend, I have to chuckle at
>this newscaster's wide eyed epiphany at "milk-sharing".
>
>
Sad though it all has to be done in private? Lest someone finds out and
it upsets them? IYKWIM?
I'm sure that there are many women around in developed nations that have
wet-nursed a baby but haven't shared it with too many people. I'm sure
those in other *under-developed* countries would think us weird that we
hide it away?
--
Merewyn Janson
RN, RM
I am finally a MIDWIFE!
Australian Breastfeeding Association counsellor ('98)
Redbank Plains, Queensland, Australia
There is no chance, no fate, no destiny that can circumvent, or hinder, or control a firm resolve of a determined soul.
- unknown
this is where we live, Google Earth 27 38 36.30S 152 52 02.48E.
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Date: Fri, 27 Jan 2006 07:59:22 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Pat Young <[log in to unmask]>
Subject: Protecting Infants Through Human Milk
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Dr Wight, where can we obtain this? Thanks, Pat in SNJ
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Date: Fri, 27 Jan 2006 08:13:16 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Ann Conlon-Smith <[log in to unmask]>
Subject: Babies R Us
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I too, saw no goodie bags being given out at the BRU seminar. However, I
did give out a slew of info, some from Medela, some from Hollister,some from
LLL and some of my own. I also gave out some protein bars for moms which was
funny because BRU had this table full of Oreos and Hi-C! Now, there's some
good pre-natal nutrtion. Oh, I forgot, yes, there were some grapes too! Ann
Ann Conlon-Smith, IBCLC Triangle Lactation Consultants
_www.trianglelactation.com_ (http://www.trianglelactation.com/)
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Date: Fri, 27 Jan 2006 08:20:16 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: Breastmilk and Prolonged lactation
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Ann asked about a study showing that human milk still packs a punch beyond
the early months of lactation. This would be in response to a pediatrician
stating that "a baby could not take in enough of this liquid to get calories."
The following article shows that the milk of mothers who have lactated over a
year contains significantly more fat and energy than the milk of mothers
lactating 2-6 months. Creamatocrit levels for mothers who had lactated 2-6 months
in this study ranged from 5% to 17.5%. Mothers who had lactated over a year
had creamatocrits that were at times extraordinarily high, up to 28%!
Mandel D, Lubetzky R, Dollberg S, et al. Fat and energy contents of
expressed human breast milk in prolonged lactation. Pediatrics 2005; 116:e432-e435
_www.pediatrics.org/cgi/doi/10.1542/peds.2005-0313_
(http://www.pediatrics.org/cgi/doi/10.1542/peds.2005-0313)
Human milk always does a body good.
Marsha Walker, RN, IBCLC
Weston, MA
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Date: Fri, 27 Jan 2006 08:29:50 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Tyler, Kara" <[log in to unmask]>
Subject: Re: Great Editorial
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Wow, thank you for posting this link, this is amazing! Anyone who =
didn't take the time to read it definitely should!
http://english.ohmynews.com/ArticleView/article_view.asp?menu=3DA11100&no=
=3D270919&rel_no=3D1&back_url=3D
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Date: Fri, 27 Jan 2006 09:09:08 EST
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Solids
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Hi Ann! If I had a call from a mom asking about the solids and told me what
that Ped had said, I would write a letter to the Ped, saying that I would be
interested in his research that supported " the baby should be eating way
more solids, that they should be the
main source of his diet, that breastmilk was not as important anymore,
should
not be offered until after the baby "eats a meal", and that the baby
"could
not take in enough of this liquid to get calories".
I would then quote studies showing the caloric values of breastmilk. I would
also ask the mother what symptoms the baby exhibited to warrant concern,
what tests the Ped conducted to show the baby was not "taking in" enough
calories. And explain to her the differences in health care professional education.
He may not have received any nutrition education in medical school.
I would explain to him who I am and what I do, and if there is a problem
with the baby's intake, certainly we would need to work together as members of
this baby's health care professional team to insure that this baby's is
receiving optimal nutrition to support his growth and development.
We don't have to "prove" ourselves, but health care professionals who
present misinformation such be called to account for it. There such be no excuse
any longer for health care professionals who misinform, mistreat their patients.
What was his plan of action, his referrals to other HCPs, etc? He just let
it go at that?
I think I would be concerned about his lack of professionalism, and
knowledge. He needs to know that "you know".
Barbara Whitehead, BS, IBCLC, RLC
eastern NC
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Date: Fri, 27 Jan 2006 09:19:52 EST
Reply-To: Lactation Information and Discussion
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From: Ann Perry <[log in to unmask]>
Subject: update on FTT case
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I just wanted to update this group on a case I shared with you a few months
ago. A quick summary; saw a 7 month old baby girl at a feeding evaluation
for Failure To Thrive. She had had problems since birth and everyone seem to
be focussing on trying to feed the baby and not getting to a diagnosis. She
had low tone, could not handle sucking from a bottle, or any kind of solids.
She did breastfeed. She had been diagnosed with Reflux and followed by a GI
doc and other tests were being done but seemed to be taking a long time to
get results.
At about 8 months this baby was admitted because even the minimal growth she
was doing stopped. She has been in a rehab hospital for the past 2 months.
This week they finally came up with the diagnosis; Rett Syndrome. This is a
metabolic genetic disorder. It is extremely rare and a poor prognosis. It
is sad that it takes so long to get to a diagnosis.
I want to thank those who sent me information.
Even though I am not involved with this case any more I needed to know why
this baby was doing so poorly. In the Internet search on this syndrome they
claim that the symptoms manifest themselves around 8 months. I can tell you
they are there from birth but some just ignore poor feeding as an underlying
red flag.
Thanks for letting me share.
Ann Perry, RN IBCLC
Boston, MA
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Date: Fri, 27 Jan 2006 08:37:20 -0600
Reply-To: Lactation Information and Discussion
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From: Sue Wilhelm <[log in to unmask]>
Subject: Sue Wilhelm is out of the office.
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I will be out of the office starting 01/27/2006 and will not return until
01/30/2006.
I will respond to your message when I return.
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Date: Fri, 27 Jan 2006 06:38:32 -0800
Reply-To: Lactation Information and Discussion
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From: MacBump <[log in to unmask]>
Subject: Re: CNN article on milk sharing
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" I agree that you have
to be careful who you are getting your milk from. I wonder about perfect
strangers, if I were going that route, I would try and use a milk bank.
However, if it is my sister, my friend etc. I think I can judge by their
lifestyles how safe their milk is. I also find it difficult to
believe that a drug
addict or someone using other risky behaviours are going to be breastfeedi=
ng
and donating anyway. "
As someone who donated milk to a friend's 2 sons (the first for 12
months, the 2nd for 6 months...these lengths of time having more to do
with how big an age gap there was between her current child and my
child than with my desire to provide milk as long as I could), I would
like to say that I would, in a heartbeat, stop providing milk and tell
her to stop using it if I had ANY doubts about the "quality" of my
milk. There could be several reasons for this, but we had an
agreement that this was how things would be done (plus I did have all
the blood tests the milk banks require repeated every 6 mos, but she
didn't pasteurize my milk). I shipped the milk on ice by Purolator to
her home, every time I had enough in my freezer.
I know without a doubt that I would rather have a trusted friend nurse
my child than use formula. I even chose my children's legal guardian
(should my husband and I die in an untimely manner) mostly because she
agreed that she would nurse them if they were still babies under about
a year when she got them...if they wanted to. She nursed all her
children to at least 2-2.5 years so I felt that was about as generous
as I could find in the people I know and who I'd feel comfortable
sending my children to.
Fio
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Date: Fri, 27 Jan 2006 09:58:45 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Susan Burger <[log in to unmask]>
Subject: Re: Listening to moms about perceived low supply
Sometimes it is very hard to get to the bottom of things especially with a baby who is older and
when the situation is atypical. This is especially hard in support groups and I always wonder
about the "missed" opportunities because you can't talk in depth.
I had one of those reminders slap me in the face recently because I had a beautiful older baby
attend support group. Mom originally had a copious milk supply and was one of those "on cue"
feeders and slept with her baby at night. She had worked hard to overcome latch on problems
initially and finally used a nipple shield. If you looked at this baby you would be absolutely certain
all was perfectly fine. YET, this intuitive mom was worried about supply. She was worried about
supply because her baby had shifted from feeding beautifully to feeding once an hour and being
very fussy. She also had bleeding nipples and soreness that she attributed to teething, but no
open lesions. So, I sent her to the breastfeeding medicine specialist just because I was nervous
about the bleeding. Its the kind of situation where one could easily try to reassure her all is well.
The baby's intake was low at support group ~ 1.5 oz the week before when my colleague was
doing the group. But I've seen plenty of distracted older babies just plain not eat at support group
because its just too exciting. And the baby is one of those pink rolly polly active babies that look
great. The next week the baby took about the same after feeding pretty much the whole 2 hours
and again took 1.5 oz. Again, I've seen some older babies do this during growth spurts or
developmental leaps and again it could be the time of day, teething - so many factors. So, I said,
let's keep a close eye on this - something does seem to be off in terms of behavior, but she's still
looking great. Only after much discussion did the potential problem emerge as an "Oh, I forgot to
tell you..." - her thyroid hormone levels were way off which was only picked up by the
breastfeeding medicine specialist testing her levels.
I've had other situations where mom thinks there isn't enough milk and everything really looks
great and only after lots and lots of discussion and trying to explore every angle and watching the
baby for several weeks does something pop out that explains what is going on. Usually one of
those "Oh I forgot to tell you that...." and it will be some critical piece of information that explains
why mom's supply has slipped. It invariably is the one item that I forgot to ask about thinking I
had covered the whole range of possibilities.
Thankfully, most of the time when moms of older babies worry about their supply it isn't a
problem and really all that is needed is reassurance, but I always remind myself to keep an eye on
things when mom has this perception because sometimes mom is right.
Best, Susan
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Date: Fri, 27 Jan 2006 07:52:46 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Susan Johnson <[log in to unmask]>
Subject: Starting Solids and Breastfeeding
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Over the 13 years I have run a monthly discussion
group for mothers nursing past 12 months, I have seen
a number of babies who show little interest in table
foods before the 2nd birthday. With rare exceptions
these are robust, healthy children whose HCPs are
delighted with their physical and mental development.
We have only a primitive understanding in the US of
normal nursing patterns, during the first year of life
as well as the years following. Certainly cultural
influences play havoc with biology for many
mother/baby pairs.
This is an area that warrants considerable research,
with an open mind to the play of culture on both
families and researchers.
Susan Johnson MFA, IBCLC
Salt Lake City, Utah USA
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Date: Fri, 27 Jan 2006 10:53:06 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Susan Burger <[log in to unmask]>
Subject: Re: Weissingerization
Dear all:
The last time I spoke about Weissingerization - I apologized directly to the person involved
because Ieaped to some conclusions (and if the person who was subjected to my frustration with
all the phone calls about Toxic Breast milk that I received is reading this - I have still not forgotten
my drifting over the edge and apologize all over again). So this time I will try to be more delicate
and thoughtful.
In the past, I have used the term "prolonged" lactation myself and I cringe every time I think that it
is in print in a manual I wrote about using the HemoCue for surveys of anemia in nutrition
programs in developing countries. But r gives the impression that something that is quite normal
is actually longer than is necessary. So rather than talking about "prolonged" lactation, we should
be using other terms. For a child under two, I would never consider it "prolonged" it is the
"recommended" duration of breastfeeding. For a child over two, I would use "child-led" nursing.
I'm sure others can pipe up with terms that can be useful. With a pediatrician that does not
understand some of the basic nutritional facts about the first year of life, I think using the
appropriate terms to normalize the discussion about nursing for an "appropriately recommended
period of time" would be helpful.
There are a lot of WHO references on appropriate intake and the LINKAGES website has a lot of
1-2 page sheets on recommended intakes. These are simple sheets designed for parents and
primary health care practitioners and though the information is designed for international
programs, the research on what babies need does not differ no matter where they live.
Nancy Wight may correct me on this, but Kay Dewey did an excellent presentation on infant and
young child nutrition about two years ago at the Academy of Breastfeeding Medicine conference.
She really emphasized iron and zinc as the first two nutrients that are needed NOT calories. Her
explanation for this was that in our preagricultural times we were probably chewing up the
random bit of meat (not corn fed and antibiotic ridden) and putting it into our babies mouths.
In fact, during her presentation, she added information that was new to me about a study in
Mexico or South America . It was not when you fed the meals (before or after the breast) but how
many meals that made a difference in growth and milk supply. When you gave 5 or more meals
between 9-12 months of age - there was too much displacement of the breast milk. When you
displace breast milk with a low calorie, low nutrient-dense food such as cereal, you can get a
slowing in the growth rate. So, I remember her suggestion of 4 small meals a day rather than 5
small meals a day in the 9-12 month range and I believe the long-used recommendation of 1-3
small meals in the 6-9 month range still held.
Susan Burger, MHS, PhD, IBCLC
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Date: Fri, 27 Jan 2006 10:55:21 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: [log in to unmask]
Subject: Protecting Infants Through Human Milk
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It is one of a series in "Advances in Experimental Biology and medicine"
published by Kluwe Academic/Plenum Publishers, New York, Boston, Dordrecht,
London, Moscow.
Nancy E. Wight MD, IBCLC, FABM, FAAP
Neonatologist
Medical Director, Lactation Services
Sharp Mary Birch Hospital for Women
San Diego, CA USA
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Date: Fri, 27 Jan 2006 10:57:23 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: "Lynnette Hafken, IBCLC" <[log in to unmask]>
Subject: Reglan and Domperidone question
Comments: cc: Barbara Dudley <[log in to unmask]>,
Diana West IBCLC <[log in to unmask]>,
Margaret Wills <[log in to unmask]>
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A mother of a former preemie just called me about increasing her milk
supply. The baby was born 3 mo early, is 6 mo old now (not corrected
age). The baby is still willing to nurse, and empties her breast
really well. She was interested in purchasing a Lact-aid. She is
mostly pumping, however, and we estimated that she is making 16 oz in
24 hours. She has been on 10 mg Reglan once/day since the baby was 3
month old. (She is also taking Fenugreek.)
According to Hale, this is a very low dose of Reglan, and she would
need to be taking more like 30-45 mg/day. However, she has been on
it for 3 months, which is a long time, and I am concerned about side
effects. She feels it has caused her to gain weight. Any thoughts
on whether she should pursue Domperidone, and how to wean off the
Reglan and onto the Domperidone (if weaning is necessary)? Or would
it be better just to up the dose of Reglan? I would love to hear
thoughts on this issue.
Sincerely,
Lynnette Hafken, MA, LLLL, IBCLC
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Date: Fri, 27 Jan 2006 08:10:56 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Susan Johnson <[log in to unmask]>
Subject: milk sharing
In-Reply-To: <[log in to unmask]>
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While I do not recommend milk sharing, I continue to
hear stories of milk sharing in my area.
Circumstances range from medical challenge to
convenience, with adoptive babies in their own arena.
I am not promoting or criticizing the practice, just
reporting that I continue to hear mothers' stories. I
suspect it is more common than we know. I share
information on milk banks and articles on health
concerns with the practice of informal milk sharing
whenever possible. But I wonder sometimes how many
mothers share milk "under wraps" with little
information about concerns -- particularly for babies
with health challenges.
I suspect that the widespread use of pumps in the US,
and the sharing of pumps (I know! I know!),
introduces the question of sharing more often. It's
just plain getting easier to borrow a cup of milk.
Susan Johnson MFA, IBCLC
Salt Lake City, Utah USA
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Date: Fri, 27 Jan 2006 13:04:56 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Lee Galasso <[log in to unmask]>
Subject: AZ Breastfeeding Legislation
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Hi Chandra,
Congratulations on the progress all of you have made.
Last year, I e-mailed a message to both councils to support your efforts and
am glad for this update. I'm also happy to see you use the following
wording in your first paragraph:
"[We] have successfully lobbied the Chandler and Tempe City Councils to
allow
children the right to breastfeed in places open to the public."
That is such an important point to keep reminding everyone that the child
has the right to eat when hungry.no matter where that occurs.
Yes, the mothers do need the protection of the law to be able to breastfeed
in public, but it is the right of the child to eat that also should be
respected and not violated. Children have civil rights just as adults do.
Keep up the good work!
Best regards,
Lee Galasso, MS, IBCLC, RLC
Lactation Specialist
Westchester County in NY State
On Tue, 24 Jan 2006 20:37:30 -0700, Chandra Ruiz [log in to unmask]
wrote:
Dear Breastfeeding Supporters,
As many of you know, in June of 2005 I was approached by a lifeguard at a
Chandler city pool in Arizona and told to nurse my child in the restroom in
the future. I was completely covered the entire time I nursed my then two
month-old son, Aiden. Since that time I, along with many other families,
have successfully lobbied the Chandler and Tempe City Councils to allow
children the right to breastfeed in places open to the public. The City of
Tucson has since created a similar ordinance and Flagstaff and Phoenix have
been requested to follow Chandler's lead.
While this started out at a city pool in Chandler and was taken up with the
Chandler City Council, mothers from across Arizona decided to work together
to take this issue to the state level. Our belief is that the state must
provide breastfeeding protection in the form of an exemption to the indecent
exposure statute and provide language that allows mothers the right to
breastfeed in places open to the public. Breastfeeding mothers are
protected on federal property already, and nearly forty other states provide
protection too, including all of Arizona's neighboring states.
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Date: Fri, 27 Jan 2006 10:06:15 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Lori Werrell <[log in to unmask]>
Subject: MPH programs
In-Reply-To: <[log in to unmask]>
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Deb,
I am currently enrolled in the MPH program with Walden
University (online) they are fully accredited. I am
doing the Community Health concentration and learning
a lot and enjoying it so far ( I am currently taking
statistics which is yucky but I'll get through. I
think it complements my LC work to a large extent.
I'd be happy to talk with you about this further off
list if you'd like.
Lori Werrell, BA,IBCLC,RLC
Lactation Consultant Coordinator
St. Mary's Hospital
Leonardtown MD
MPH Student Walden University
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Date: Fri, 27 Jan 2006 13:43:52 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Nikki Lee <[log in to unmask]>
Subject: informal milk sharing
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In a message dated 1/27/2006 9:09:56 AM Eastern Standard Time,
[log in to unmask] writes:
I also find it difficult to believe that a drug
addict or someone using other risky behaviours are going to be
breastfeeding
and donating anyway. Too much work, they have more "important" things on
their mind, if you know what I mean.
Dear Friends:
While this may be true, another worry about informal sharing is the
exchange of viruses. Some of these viruses have long lives, or stay dormant for a
long time.
I am talking about the strains of HIV, of HTLV-1, and of CMV.
warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Maternal-Child Adjunct Faculty Union Institute and University
Film Reviews Editor, Journal of Human Lactation
www.breastfeedingalwaysbest.com
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Date: Fri, 27 Jan 2006 20:59:22 +0200
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: EDG <[log in to unmask]>
Subject: Major epidemiological changes in sudden infant death syndrome
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http://www.thelancet.com/journals/lancet/article/PIIS0140673606679683/ab
stract
also read this one:=20
http://www.thelancet.com/journals/lancet/article/PIIS0140673604161710/fu
lltext?pubType=3Drelated
The Lancet=A02006;=A0367:314-319
Major epidemiological changes in sudden infant death syndrome: a 20-year
population-based study in the UK
Peter S=A0Blair=A0a, =A0 Peter=A0Sidebotham=A0c, =A0 P =
Jeremy=A0Berry=A0b, =A0
Margaret=A0Evans=A0d =A0 and =A0 Peter J=A0Fleming=A0=A0a=A0
Summary
Background
Results of case-control studies in the past 5 years suggest that the
epidemiology of sudden infant death syndrome (SIDS) has changed since
the 1991 UK Back to Sleep campaign. The campaign's advice that parents
put babies on their back to sleep led to a fall in death rates. We used
a longitudinal dataset to assess these potential changes.
Methods
Population-based data from home visits have been collected for 369
consecutive unexpected infant deaths (300 SIDS and 69 explained deaths)
in Avon over 20 years (1984=962003). Data obtained between 1993 and 1996
from 1300 controls with a chosen =93reference=94 sleep before interview =
have
been used for comparison.
Findings
Over the past 20 years, the proportion of children who died from SIDS
while co-sleeping with their parents, has risen from 12% to 50%
(p<0=B70001), but the actual number of SIDS deaths in the parental bed =
has
halved (p=3D0=B701). The proportion seems to have increased partly =
because
the Back to Sleep campaign led to fewer deaths in infants sleeping
alone=97rather than because of a rise in deaths of infants who =
bed-shared,
and partly because of an increase in the number of deaths in infants
sleeping with their parents on a sofa. The proportion of deaths in
families from deprived socioeconomic backgrounds has risen from 47% to
74% (p=3D0=B7003), the prevalence of maternal smoking during pregnancy =
from
57% to 86% (p=3D0=B70004), and the proportion of pre-term infants from =
12%
to 34% (p=3D0=B70001). Although many SIDS infants come from large =
families,
first-born infants are now the largest group. The age of infants who
bed-share is significantly smaller than that before the campaign, and
fewer are breastfed.
Interpretation
Factors that contribute to SIDS have changed in their importance over
the past 20 years. Although the reasons for the rise in deaths when a
parent sleeps with their infant on a sofa are still unclear, we strongly
recommend that parents avoid this sleeping environment. Most SIDS deaths
now occur in deprived families. To better understand contributory
factors and plan preventive measures we need control data from similarly
deprived families, and particularly, infant sleep environments.
Affiliations
a Institute of Child Life and Health, Department of Clinical Science,
University of Bristol, UK
b Department of Pathology and Microbiology, University of Bristol
c University of Warwick, Department of Child Health
d Department of Paediatric Pathology, St Michaels Hospital Bristol
Correspondence to: Prof Peter Fleming, Institute of Child Life and
Health, UBHT Education Building, Bristol, BS2 8AE, UK
Related Articles=20
=95 Sudden unexpected infant death: infanticide or... =95 =93New=94 =
practice of
bedsharing and risk of SIDS=20
=95 Bedsharing and sudden infant death syndrome (SIDS)... =95 Sudden
unexplained infant death in 20 regions in...=20
=95 More related articles...=20
=20
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Date: Fri, 27 Jan 2006 15:25:42 -0500
Reply-To: Lactation Information and Discussion
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Subject: Listserv award opportunity for Lactnet.
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Dear L-Soft Donation Recipient,
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Date: Fri, 27 Jan 2006 16:29:29 EST
Reply-To: Lactation Information and Discussion
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From: Renee Drake <[log in to unmask]>
Subject: milk sharing
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In a message dated 1/27/2006 12:24:59 P.M. Pacific Standard Time,
[log in to unmask] writes:
While this may be true, another worry about informal sharing is the
exchange of viruses. Some of these viruses have long lives, or stay dormant
for a
long time.
I am talking about the strains of HIV, of HTLV-1, and of CMV.
warmly,
I totally agree with you Nikki. I believe we need to be quite careful of
who we entrust to feed our children. When I "came out" about what my friend
was doing, it was incredible the response I got from many of my "friends". You
would have thought I was out at 2 am walking the river front at the homeless
camps looking for the dingiest, dirtiest, most drugged out woman there to
nurse my baby. While I understand that there are other ways to contract said
viruses, knowing a person's history is important. The woman who volunteered
is a very religious woman whose only vice was that she smoked as a teenager.
To be totally honest, as a nurse, I have been exposed to more viruses than
the average person...so potentially I could be more of a risk to my child than
she was. No one suggests that every woman be tested for every thing before
she is allowed to breastfeed. My goodness, I hope that is never made to be
the case. I have to say that the vast, vast majority of women who are going to
actively nursing their own baby, not to mention someone else's is going to
have led a clean lifestyle. I agree that we must be careful, and if I would
have had the least amount of doubt I would have asked her to be tested and I
am sure she would have, and still would be tested. Would I go out and hold up
a sign..."get yourself a wet nurse" of course not. If someone asked me my
opinion, I would of course tell them to test the mother. (after all we do
live in a sue happy society). I would never use it as an option as a nurse,
through LLL, or elsewhere. I would recommend (and have recommended) milk banks
first. I am very grateful I was able to find such a caring, sweet soul,
willing to give my child a gift that at the time I could not give myself.
Would I do it again??? ABSOLUTELY!!!
Renee Drake RN CLC
(http://www.snugglepie.com/)
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Date: Fri, 27 Jan 2006 16:39:44 -0500
Reply-To: Lactation Information and Discussion
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From: Margaret Wendt <[log in to unmask]>
Subject: Re: Weissingerization
Susan Burger wrote about the term prolonged lactation. I have received a
flyer from the Australian Breastfeeding Association (a fantastic wonderful
organisation) for their "Breastfeeding Making a Difference" Seminar.
I was a little concerned to find listed Dr Alison Barrett's presentation -
Xtreme Breastfeeding - Feeding the older child. It makes it sound as if
feeding an older child is something unusual and a little dangerous.
If lactation health professionals and support groups put this 'label' on
breastfeeding an older child - no wonder our mum's ask "how long should I
feed for?" - which is probably one of the most common questions I get
asked.
I have to say that I am in no way 'having a go' at the Australian
Breastfeeding Association. They present great workshops enabling us all to
keep up our knowledge, and are an amazing support for me in my role as a
hospital based Lactation Consultant.
Margaret Wendt CN IBCLC
Brisbane Australia
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Date: Sat, 28 Jan 2006 08:41:21 +1100
Reply-To: Lactation Information and Discussion
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From: Karleen Gribble <[log in to unmask]>
Subject: Re: Weissingerization
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Hi Susan,
This language issue is something that I've wrested with in relation to my
toddler+ breastfeeding study. The words that are available are prolonged,
long-term and sustained. I too have rejected using prolonged for the reason
you mentioned. I don't mind sustained but I have also found it awkward to
use. I am finding myself favouring using long-term because it does not
necessarily imply "longer than normal" ... think about other ways the term
is used eg "long-term relationship" however, I'm interested in the opinions
of others on this.
One language change that I would like to see is for people to stop talking
about breastfeeding babies or infants (presuming only children under 12
months breastfeed) and start talking about breastfeeding babies or infants
and young children....policy documents etc will often need adjustment.
Karleen Gribble
Australia
> In the past, I have used the term "prolonged" lactation myself and I
cringe every time I think that it
> is in print in a manual I wrote about using the HemoCue for surveys of
anemia in nutrition
> programs in developing countries. But r gives the impression that
something that is quite normal
> is actually longer than is necessary. So rather than talking about
"prolonged" lactation, we should
> be using other terms. For a child under two, I would never consider it
"prolonged" it is the
> "recommended" duration of breastfeeding. For a child over two, I would
use "child-led" nursing.
>
> I'm sure others can pipe up with terms that can be useful. With a
pediatrician that does not
> understand some of the basic nutritional facts about the first year of
life, I think using the
> appropriate terms to normalize the discussion about nursing for an
"appropriately recommended
> period of time" would be helpful.
>
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Date: Fri, 27 Jan 2006 14:24:12 -0800
Reply-To: Lactation Information and Discussion
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From: Ellen Steinberg <[log in to unmask]>
Subject: Relationship between excessive foremilk intake and digestive
disturbances
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It is widely believed that babies who consume mostly foremilk may suffer
from diarrhea or other gastrointestinal disturbances and discomforts. I
have not read any research that definitively has studied this phenomenon.
If you know of any studies that are conclusive in this area, please respond.
I have another theory to propose, and I wonder if any of you has also
considered this:
What if these gastrointestinal disturbances are not caused by the quality of
the milk ("foremilk has too little fat and too few calories") but by the
quantity of milk. Permit me to explain further. If a mother has an
overwhelming milk supply, we recommend to her that she breastfeed on one
side until that breast is empty before she switches to the other breast.
Often, these mothers end up using just one breast at each feeding. This
helps to reduce her milk supply due to the negative feedback her breasts get
when they reach their storage capacity. This technique also happens to
decrease the likelihood that the baby will get mostly foremilk. It has been
assumed that since this one-sided nursing technique does result in a
decrease in digestive problems, it must be that the etiology of the
digestive disturbances is the baby consuming too much foremilk.
What happens when a baby simply consumes too much food? He also experiences
gastrointestinal disturbances and changes in the bowel movements. Perhaps,
what we are seeing as too much foremilk is just a situation in which the
baby is consuming too much milk overall. The mother who produces an
overabundant milk supply may believe that she needs to breastfeed for X
number of minutes per breast (i.e.15-20 minutes per breast), and that if her
baby doesn't stay on the breast for that long, he must not be eating enough
milk.
Case in point - I was contacted by a mother of a 3 week old baby who was
concerned that her baby would only breastfeed for 5 minutes per breast and
then would refuse to continue to nurse and would spit up half of what he
ate. This 7 lb-8 oz baby was fussy, gassy, and had runny bowel movements.
During the consultation, the baby gulped constantly for 4 minutes and then
was not interested in continuing to breastfeed. Test weights showed that he
consumed 4 ozs in 4 minutes. No wonder he was always spitting up and
uncomfortable! When the mother realized that the baby was overeating, she
learned to follow the baby's feeding cues and worked on decreasing her milk
supply. Within 24 hours the baby's symptoms disappeared and he was calm and
comfortable.
This is just one dramatic example out of hundreds of cases I've had where
helping the mom understand her milk supply and her baby's response to it led
to a quick and easy resolution of the problem.
I recognize the benefit of understanding the difference between foremilk and
hindmilk. However, I have also heard from many mothers how their milk must
be "bad" because they were told that they had too much foremilk which didn't
have enough fat content so either their baby is not gaining weight or the
excessive foremilk is causing the baby too much distress. Mothers have no
easy way of knowing at what point in the feeding their foremilk has
transitioned into hindmilk. But for those mothers who have been led to
believe that their milk quality is inappropriate, we might better help them
by evaluating whether their milk quantity is not appropriate (either too
much milk, as in the case above, or perhaps too little - but that is another
one of my favorite topics which will have to wait for a different posting.)
I welcome your comments on this issue.
============================================
Ellen A. Steinberg, RN, LCCE, IBCLC
E-mail: [log in to unmask]
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Date: Fri, 27 Jan 2006 18:21:58 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Catherine Watson Genna, IBCLC" <[log in to unmask]>
Subject: Re: Weissingerization
In-Reply-To: <006c01c6238a$6b448730$0801a8c0@Karleen>
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I like to talk about breastfeeding for a "biologically appropriate"
time, but that's a little cumbersome too.
Sigh.
Catherine Watson Genna, IBCLC NYC
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Date: Fri, 27 Jan 2006 17:38:43 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Julia R. Barrett" <[log in to unmask]>
Subject: OT: draft report on soy formula effects
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Since the topic of reproductive and developmental effects of soy formula
has appeared on the list several times in the past, I thought there'd be
interest in the following draft report. The report is from the Center for
the Evaluation of Risks to Human Reproduction and is available at
<http://cerhr.niehs.nih.gov>. (Click on the "soy formula" link on the right
side of the screen. The report is 192 pages, so it may take a bit of time
to download.) The Federal Register notice is at
<http://cerhr.niehs.nih.gov/news/fedreg/fr12-16-2005.pdf>.
regards,
Julia
Julia R. Barrett
Freelance Science Writer & Editor
Mom to Sean (6) and Kira (2)
Madison, Wisconsin
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Date: Fri, 27 Jan 2006 19:22:09 -0500
Reply-To: Lactation Information and Discussion
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From: "Christine Erland RN.IBCLC" <[log in to unmask]>
Subject: Re: Difficult Staff and Rotten Tomatoes
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Esther, I would love a copy of your list. What a wonderful idea
to defuse defensiveness, help everyone to laugh, relax and
learn. Chris Erland RN IBCLC
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Date: Fri, 27 Jan 2006 18:46:40 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Jeanette Panchula <[log in to unmask]>
Subject: Bilirubin treatment
In-Reply-To: <[log in to unmask]>
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Has anyone used the following tool? http://www.bilitool.org/
Just curious how it reflects your experiences?
Jeanette Panchula, BSW, RN, PHN, IBCLC
California, USA
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Date: Fri, 27 Jan 2006 18:58:07 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Judy Ritchie <[log in to unmask]>
Subject: Wonder if his baby is breastfed?
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One New Scientist contest winner, a new dad says:
ACTUALLY, right now all I'd like for Christmas is a small gauge on the
forehead of my 4-month-old daughter. It would simply read from "empty" to
"full". I cannot tell you what a difference that would make to our lives.
Mark Fletcher, Neutral Bay, New South Wales, Australia
from
http://www.newscientist.com/backpage.ns?id=mg18825316.300
Feedback
. 24 December 2005
FORGET intelligent design - we suffer from damn stupid design, as many
readers noted in response to our seasonal competition, which asked how you
would modify the human body if you were not restricted in any way.
Judy Ritchie
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Date: Fri, 27 Jan 2006 22:11:28 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Diane Wiessinger <[log in to unmask]>
Subject: Re: Wiessingerization
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That's a mouthful! Just remember i before e and "I sing, you sing, =
Wiessinger."
I'm not sure we need a term for nursing a toddler or preschooler or =
whatever. I just talk about, um, nursing a toddler or preschooler or =
whatever. We could also say "breastfeeding past a year" or =
"breastfeeding past 4." We don't talk about extended living, or =
long-term living. We just talk about senior citizens, or having a good =
long life, or being in our 80s. I wonder: is there perhaps some =
lingering sense of judgment in a culture's desire to label a length of =
time in nurslings when we don't do it later on?
Diane Wiessinger, MS, IBCLC Ithaca, NY USA
www.wiessinger.baka.com
who plans to put on her tombstone "She died a verb"
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Date: Sat, 28 Jan 2006 11:37:58 +0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Joy Anderson <[log in to unmask]>
Subject: Re: Relationship between excessive foremilk intake and digestive
disturbances
Comments: cc: Ellen Steinberg <[log in to unmask]>
In-Reply-To: <[log in to unmask]>
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Ellen Steinberg wrote:
>It is widely believed that babies who consume mostly foremilk may suffer
>from diarrhea or other gastrointestinal disturbances and discomforts. I
>have not read any research that definitively has studied this phenomenon.
>If you know of any studies that are conclusive in this area, please respond.
>
>I have another theory to propose, and I wonder if any of you has also
>considered this:
>
>What if these gastrointestinal disturbances are not caused by the quality of
>the milk ("foremilk has too little fat and too few calories") but by the
>quantity of milk.
<snip>
Absolutely, Ellen. I agree with you completely. This is something I
have been preaching for many years. I see the problem as 'lactose
overload' from too much milk too fast. I also have had personal
experience with this.
See my article on lactose intolerance on the Australian Breastfeeding
Association website, in particular, the last section on lactose
overload at http://www.breastfeeding.asn.au/bfinfo/lactose.html This
is often misdiagnosed as lactose intolerance.
I think that we often put too much emphasis on foremilk and hindmilk,
and trying to explain things to mothers using these terms can cause
more problems than it solves.
Joy
--
******************************************************************
Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Australian Breastfeeding Association counsellor
Perth, Western Australia. mailto:[log in to unmask]
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Date: Fri, 27 Jan 2006 19:40:25 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Joanna Koch <[log in to unmask]>
Subject: Re: excessive foremilk intake and digestive disturbances
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Ellen brings up a most excellent issue. I hope I am summarizing her
comments correctly as "is it the quantity or the quality" that is causing
g.i. distress? A wise physician once told me that if she met a baby gaining
1#/week then she would expect it to be colicky (of course not always the
case but you get the idea). She explained that, tho all babies make
lactase, they only make so much. So, if the intake is considerable (and
some of these little ones are amazing what they can consume) necessarily
some of the lactose will not be digested before reaching the colon. I've
heard this termed "overfeeding colic". Sometimes limiting a baby to the
same breast for several feeds will do the trick.
A huge issue in my area is *starving in the quest for the holy grail of
hindmilk*. Is anyone else seeing this? The mother reads that hindmilk is
the good stuff and baby should therefore empty the breast - one breast is
probably enough. Regardless of supply and demand mom then limits baby to
one breast - gotta get that hindmilk! Baby gains slowly and mom's supply is
shot by the time she's referred to me.
The misperception that hindmilk is this hard-to-extract separate entity
living deep within the breast is messing with women's common sense (i.e.
feed the baby - not just let baby suck for hours). Foremilk/hindmilk
imbalance is rare yet most of the women I meet (older, professional, busy on
internet) worry about it. Sigh. And most of the babies I meet are fussy
coz underfed, not because they need more fat in milk. I like to remind moms
we managed to feed our babies for thousands of years, not by worrying about
time, or fat content, but probably by watching the baby. As Rebecca Glover
says "Follow Me Mum".
Joanna Koch, IBCLC N Ca
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Date: Fri, 27 Jan 2006 23:03:46 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Jennifer Tow, IBCLC" <[log in to unmask]>
Subject: Re: excessive foremilk
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Ellen,
I think there are some other significant issues to consider. First,
when babies are "gulping down" 4 oz in 4 minutes, there is not a lot of
tongue peristalsis going on. Since gut peristalsis is in part dependent
upon the peristalsis of the tongue, it seems to me that these babies
would have digestive issues originating with the physiology of simply
having to manage the rapid flow. Another concern that I continue to
raise and have seen no reponse to is the issue of babies growing very
rapidly on sugar (lactose) and how this may have long-term implications
for development of type 2 diabetes. While I do see that tamping down
the supply is beneficial, I also believe that fixing the latch is the
real long-term solution to "oversupply' problems.
Jennifer Tow, IBCLC, CT, USA
Date: Fri, 27 Jan 2006 14:24:12 -0800
From: Ellen Steinberg <[log in to unmask]>
Subject: Relationship between excessive foremilk intake and digestive
disturbances
It is widely believed that babies who consume mostly foremilk may suffer
from diarrhea or other gastrointestinal disturbances and discomforts.
I
have not read any research that definitively has studied this
phenomenon.
If you know of any studies that are conclusive in this area, please
respond.
I have another theory to propose, and I wonder if any of you has also
considered this:
What if these gastrointestinal disturbances are not caused by the
quality of
the milk ("foremilk has too little fat and too few calories") but by the
quantity of milk. Permit me to explain further. If a mother has an
overwhelming milk supply, we recommend to her that she breastfeed on one
side until that breast is empty before she switches to the other breast.
Often, these mothers end up using just one breast at each feeding. This
helps to reduce her milk supply due to the negative feedback her
breasts get
when they reach their storage capacity. This technique also happens to
decrease the likelihood that the baby will get mostly foremilk. It has
been
assumed that since this one-sided nursing technique does result in a
decrease in digestive problems, it must be that the etiology of the
digestive disturbances is the baby consuming too much foremilk.
What happens when a baby simply consumes too much food? He also
experiences
gastrointestinal disturbances and changes in the bowel movements.
Perhaps,
what we are seeing as too much foremilk is just a situation in which the
baby is consuming too much milk overall. The mother who produces an
overabundant milk supply may believe that she needs to breastfeed for X
number of minutes per breast (i.e.15-20 minutes per breast), and that
if her
baby doesn't stay on the breast for that long, he must not be eating
enough
milk.
Case in point - I was contacted by a mother of a 3 week old baby who was
concerned that her baby would only breastfeed for 5 minutes per breast
and
then would refuse to continue to nurse and would spit up half of what he
ate. This 7 lb-8 oz baby was fussy, gassy, and had runny bowel
movements.
During the consultation, the baby gulped constantly for 4 minutes and
then
was not interested in continuing to breastfeed. Test weights showed
that he
consumed 4 ozs in 4 minutes. No wonder he was always spitting up and
uncomfortable! When the mother realized that the baby was overeating,
she
learned to follow the baby's feeding cues and worked on decreasing her
milk
supply. Within 24 hours the baby's symptoms disappeared and he was
calm and
comfortable.
This is just one dramatic example out of hundreds of cases I've had
where
helping the mom understand her milk supply and her baby's response to
it led
to a quick and easy resolution of the problem.
I recognize the benefit of understanding the difference between
foremilk and
hindmilk. However, I have also heard from many mothers how their milk
must
be "bad" because they were told that they had too much foremilk which
didn't
have enough fat content so either their baby is not gaining weight or
the
excessive foremilk is causing the baby too much distress. Mothers have
no
easy way of knowing at what point in the feeding their foremilk has
transitioned into hindmilk. But for those mothers who have been led to
believe that their milk quality is inappropriate, we might better help
them
by evaluating whether their milk quantity is not appropriate (either too
much milk, as in the case above, or perhaps too little - but that is
another
one of my favorite topics which will have to wait for a different
posting.)
I welcome your comments on this issue.
============================================
Ellen A. Steinberg, RN, LCCE, IBCLC
E-mail: [log in to unmask]
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Date: Fri, 27 Jan 2006 23:24:36 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: "Jennifer Tow, IBCLC" <[log in to unmask]>
Subject: Re: duration of breastfeeding
In-Reply-To: <[log in to unmask]>
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I think that the issue is less of what is appropriate than what is not.
I refer more often to premature weaning than I do to any specific
length of time for breastfeeding. If I do have to address breastfeeding
in such terms, I usually simply say "normal breastfeeding". I cannot
imagine a perfect word, b/c from our frame of reference, we take for
granted that breastfeeding happens until it is finished happening. How
do we convey this to someone who has a whole other frame of reference?
Jennifer Tow, IBCLC, CT, USA
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Date: Sat, 28 Jan 2006 12:38:56 +0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Lara <[log in to unmask]>
Subject: Re: Weissingerization
In-Reply-To: <006c01c6238a$6b448730$0801a8c0@Karleen>
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On 28/01/2006, at 5:41, Karleen Gribble wrote:
> This language issue is something that I've wrested with in relation
> to my
> toddler+ breastfeeding study. The words that are available are
> prolonged,
> long-term and sustained.
I have heard "full-term breastfeeding" used also, for either a child-
led approach or for breastfeeding to at least 12/24 months. The
downside is "is there such a thing as post-term breastfeeding?", but
it does lend itself to a change in viewpoint - by the implication
that there is also such a thing as "premature" cessation, with
accompanying health risks.
Lara Hopkins
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Date: Fri, 27 Jan 2006 23:39:53 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Mirine Dye <[log in to unmask]>
Subject: Seizing Mothers as war tactic
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This may be more of a political issue than a lactation one, however, =
this reaffirms the use of women as tools of war, and breastfeeding women =
as well.
http://news.yahoo.com/s/ap/20060128/ap_on_re_mi_ea/iraq_leveraging_wives;=
_ylt=3DArKpVWQwm8WUF1z8HPcfhW6s0NUE;_ylu=3DX3oDMTA3b2NibDltBHNlYwM3MTY-
"The 28-year-old woman had three young children at the house, one being =
as young as six months and still nursing," the intelligence officer =
wrote. She was held for two days and was released after he complained, =
he said.=20
~~~~~~~~~~~~~~~~~~~~~~~
Mirine R. Dye, CCE,CD,CLE
Florida Keys
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Date: Fri, 27 Jan 2006 21:07:43 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: Ellen Steinberg <[log in to unmask]>
Subject: Breastfeeding and pumping during subsequent pregnancy
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I am working with a mother who became pregnant when her exclusively
breastfed baby was 4 months old. She is now 6 months pregnant and her
daughter is 10 months old. Shortly after becoming pregnant she noticed a
significant decrease in her milk supply, but she continued to nurse her baby
2-3 times per day, while supplementing with formula, and after 6 months,
with solids. As of last week, the infant refused to breastfeed. The mother
was hoping to continue breastfeeding throughout the pregnancy and then to
tandem nurse. I gave her all of the usual suggestions for how to handle a
nursing strike, and explored with mom her reasons for wanting to continue
breastfeeding. She said she is primarily interested because she is not yet
ready to give up the bonding that breastfeeding achieves. Mom thinks that
the baby won't nurse because of severely decreased milk supply. She asked
if she could use a breastpump to increase her supply so that she might
rekindle her baby's interest in breastfeeding. I told her that pumping
might pose a risk to her pregnancy.
Does anyone have any research about the impact of pumping or hand expression
on pregnancy? What would you think is the difference between breastfeeding
and pumping during pregnancy? Why would it be safe to continue
breastfeeding, but not safe to use a breastpump? What if she limited her
pumping to the 2-3 times per day that her baby would ordinarily be nursing,
to help maintain whatever supply she might still have until the baby might
stop her nursing strike?
============================================
Ellen A. Steinberg, RN, LCCE, IBCLC
E-mail: [log in to unmask]
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Date: Fri, 27 Jan 2006 21:28:28 -0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Ellen Steinberg <[log in to unmask]>
Subject: Relationship between excessive foremilk intake and digestive
disturbances
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Thank you Joy, for letting me know about your article entitled "Lactose
Intolerance and the Breastfed Baby". This information does help me to
better understand why overfeeding leads to discomfort. I recommend that
other readers of Lactnet take a look at this piece.
Joanna, I agree that many of the moms I see are worried that their babies
won't get enough hindmilk. When the moms mention this concern in my
breastfeeding support group, all of the other mothers chime in with, "I
heard about that. Should I be worried about my hindmilk, too?" This
concept seems to be spreading like wildfire in my community too.
And yes, I do see many more moms with insufficient milk supply instead of
oversupply. Of course, these babies are also very fussy. But oftentimes I
need to spend an inordinate amount of time convincing the mom that the milk
she is making is perfect, but there's just not enough of it. Test weights
often help mom to believe me when I tell her this.
There are several books on breastfeeding that strongly encourage
single-sided nursing. Although this technique may be the best choice for
some mothers and babies, I think that single-sided nursing is indeed often
the cause of insufficient milk supply and poor weight gain, not to mention
an increased risk of plugged ducts.
============================================
Ellen A. Steinberg, RN, LCCE, IBCLC
Telephone: (818) 345-4439
Cell Phone: (818) 929-7584
E-mail: [log in to unmask]
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Date: Sat, 28 Jan 2006 14:12:07 +0800
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Joy Anderson <[log in to unmask]>
Subject: Re: excessive foremilk
Comments: cc: "Jennifer Tow, IBCLC" <[log in to unmask]>
In-Reply-To: <[log in to unmask]>
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Jennifer Tow wrote:
>I think there are some other significant issues to consider. First,
>when babies are "gulping down" 4 oz in 4 minutes, there is not a lot of
>tongue peristalsis going on. Since gut peristalsis is in part dependent
>upon the peristalsis of the tongue, it seems to me that these babies
>would have digestive issues originating with the physiology of simply
>having to manage the rapid flow.
Jennifer, do you have a reference for this idea that peristalsis in
the gut is dependent in part on that of the tongue? I have never
heard this before. In adults, peristalsis begins with the swallow,
and control of peristalsis in various parts of the digestive system
is controlled by complex nerve processes and hormones, according to
their contents.
> Another concern that I continue to
>raise and have seen no reponse to is the issue of babies growing very
>rapidly on sugar (lactose) and how this may have long-term implications
>for development of type 2 diabetes. While I do see that tamping down
>the supply is beneficial, I also believe that fixing the latch is the
>real long-term solution to "oversupply' problems.
>
I was taught in my university nutrition course that the assumption
that diabetes is caused by too much sugar is no longer current.
Obesity and consumption of fat are responsible, not sugar.
Also, I didn't think babies 'grew rapidly on lactose' - they grow on
fat, protein, growth factors and everything else in the milk.
Besides, babies getting too much lactose don't absorb all of it - the
excess is fermented by bacteria to produce acids and gas in the colon
(which cause the colicky symptoms).
I certainly agree that latch is important, but I maintain that you
can have oversupply, with too much milk too fast, with a perfect
latch.
Joy
--
******************************************************************
Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Australian Breastfeeding Association counsellor
Perth, Western Australia. mailto:[log in to unmask]
******************************************************************
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Date: Sat, 28 Jan 2006 20:03:55 +1100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Barbara Glare & Chris Bright <[log in to unmask]>
Subject: Re: LACTNET Digest - 27 Jan 2006 - Special issue (#2006-91)
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Hi, Margaret,
I put that brochure and the seminar for together. It will be a fabulous
seminar (www.lrc.asn.au) As you rightly point out it will be fabulous.
It was the speaker's title. And we felt it would catch people's attention
(looks like we are right)
My 3rd darling Cassie celebrated her 8th birthday with a very girly
saddleclub party for her 4 closest friends with horse-riding and lots of the
Blackeyed Peas and Hilary Duff at the barbeque afterwards.
She had her last breastfeed about 1 month before her 8th birthday. It feels
very normal to me. Not Xtreme at all to me. But culturally it is a little
unusual. I see my work collegues quickly and carefully rearrange there faces
so that hopefully no-one notices that their jaws have hit the floor. I've
always fed her anytime, anywhere, and no-one's ever said a word. I have to
have a giggle, when she was 11mnths I was in ICU after having an asthma
attack. When I mentioned I was breastfeeding and needed the pump, the nurse
said "oh, this will be a great opportunity, you can wean her now......"
Barb
www.mothersidirect.com.au
Mum of Zac, 12, Dan 10, Cassie, 8 and Guan 3
Director, Australian Breastfeeding Association
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Date: Sat, 28 Jan 2006 21:57:36 +1100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Karleen Gribble <[log in to unmask]>
Subject: Xin Nian kuai le =?utf-8?Q?=E6=96=B0=E5=B9=B4=E5=BF=AB=E4=B9=90?=
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Just thought I'd send a happy Chinese new year to all who celebrate. I =
don't think we have any Chinese based Lactnetters, lets hope we do =
sometime, there's a heck of a lot of babies born there and a lot of Baby =
friendly hospitals!
=E6=96=B0=E5=B9=B4 =E5=BF=AB=E4=B9=90
We've just stuffed ourselves with jiaozi surrounded by red lanterns and =
my Chinese breastfeeding art collection! Very satisfying!
Karleen Gribble
Australia
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Date: Sat, 28 Jan 2006 22:35:00 +1100
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Karleen Gribble <[log in to unmask]>
Subject: Re: Wiessingerization
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But we do in some circumstances... we do talk about "long term"
relationships.. and "short term relationship" There's no negativity
associated with beiing in a long term relationship, in fact it's usually
viewed very positively.
I've found in talking about "breastfeeding that continues" that it is
necessary to use an adjective to describe it. Mind you in some studies
"long-term" is 4 months or more! Now *that* is an indictment on the society
in which the phrase was used!
Karleen Gribble
Australia
PS. another descriptor used that I didn;t mention before is "extended",
definitely don't like that one.
> I'm not sure we need a term for nursing a toddler or preschooler or =
> whatever. I just talk about, um, nursing a toddler or preschooler or =
> whatever. We could also say "breastfeeding past a year" or =
> "breastfeeding past 4." We don't talk about extended living, or =
> long-term living. We just talk about senior citizens, or having a good =
> long life, or being in our 80s. I wonder: is there perhaps some =
> lingering sense of judgment in a culture's desire to label a length of =
> time in nurslings when we don't do it later on?
>
> Diane Wiessinger, MS, IBCLC Ithaca, NY USA
> www.wiessinger.baka.com
> who plans to put on her tombstone "She died a verb"
>
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Date: Sat, 28 Jan 2006 07:06:00 -0600
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Evelyn Landry <[log in to unmask]>
Subject: Hospital Lactation Program
Comments: cc: [log in to unmask]
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We are in the process of trying to improve our services and are considering
offering a "pre-delivery" evaluation as well as possibly a "3rd day after
delivery" clinic for breastfeeding assistance. If anyone is willing to
share how their hospital program works it would be greatly appreciated. I
also have questions about insurance coverage for these types of visits. At
this time we try to work with all the breastfeeding moms while they are in
the hospital, and also provide assistance after discharge if needed - all at
no charge. I think some mothers are too overwhelmed to even make the
decision to call or come in, and just give up. If we had an established
"check up" clinic for weight checks, observing a feeding, and for
encouragement, maybe we could get more mothers past that first week.
If anyone would like to share ideas, please e-mail me at <[log in to unmask]>
Thank you in advance,
Evelyn Landry, RN, IBCLC, RLC
Lafayette General Medical Center
Lafayette, Louisiana
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Date: Sat, 28 Jan 2006 08:20:28 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Diane Wiessinger <[log in to unmask]>
Subject: how long is long?
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>I have heard "full-term breastfeeding" used also, for either a child-=20
>led approach or for breastfeeding to at least 12/24 months.=20
There's still a sense of cultural judgment in that, though... and =
misplaced, since "full-term breastfeeding" probably doesn't really start =
until around 30 months. We have a long way to go before this culture =
grasps the notion that the baby who nurses to 2 1/2 has only just =
entered the apparently physiologically normal "weaning window" of 2 1/2 =
to 7 years. =20
Diane Wiessinger, MS, IBCLC Ithaca, NY USA
www.wiessinger.baka.com
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Date: Sat, 28 Jan 2006 10:19:02 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Ann Perry <[log in to unmask]>
Subject: informal milk sharing
Comments: cc: [log in to unmask]
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In a message dated 1/27/2006 3:25:04 PM Eastern Standard Time,
[log in to unmask] writes:
I am talking about the strains of HIV, of HTLV-1, and of CMV.
Nikki, and others, I ask this question: with your worries of informal milk
sharing how many mothers are breastfeeding their own children with HIV or
HTLV-1?
Both of these viruses are contraindicated for breastfeeding in the USA. So
when we tell mothers they should not milk share because of these viruses are
we saying that potentially all nursing mothers could have these viruses?
I'm playing the devil's advocate here and very much believe in universal
precautions but I also do not believe we have rampant out breaks of these
viruses and that milk sharing is a safer bet that formula.
Having a history from a mother who wants to help out another mother is good
but setting fear into them I think is unreasonable.
Ann Perry, RN IBCLC
Boston, MA
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Date: Sat, 28 Jan 2006 10:54:26 EST
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Ann Perry <[log in to unmask]>
Subject: Relationship between excessive foremilk intake and digestive
disturbances
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What I have observed regarding mothers with excessive milk supplies is the
increase diagnosis of GERD. With this diagnosis comes the prescribing of
medications.
I find this disturbing that so many babies are on medication for GERD.
When I have a mother calling with the problem of over production by the time
I get their supply down to a reasonable flow and amount their babies are
still having symptoms of reflux. The mothers of course are concerned and seek
medical help. Most of the mothers tell me their babies symptoms went away
with the medications. Does this mean her over production went on too long?
There really needs to be more research in the relationship of over
production and GERD. If a mother who has a tendency to over produce were addressed
earlier, would this prevent the baby developing GERD? Another category of
babies who get diagnosed with GERD are preemies who are getting fed with both
breast and bottles.
I hate seeing the solution being giving a pill when there is so much not
answered to why these babies have developed the problem in the first place.
Ann Perry, RN IBCLC
Boston, MA
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Date: Sat, 28 Jan 2006 10:54:47 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Lynnette Hafken, IBCLC" <[log in to unmask]>
Subject: Re: Weissingerization
On Fri, 27 Jan 2006 18:21:58 -0500, Catherine Watson Genna, IBCLC <[log in to unmask]>
wrote:
>I like to talk about breastfeeding for a "biologically appropriate"
>time, but that's a little cumbersome too.
>Sigh.
>Catherine Watson Genna, IBCLC NYC
How about breastfeeding "for as long as the child needs it"? When people then ask "how long do
children 'need' to breastfeed?" you can get into a discussion of how the infant's body is not designed
to process *anything* other than human milk for six months, then how the child's brain and immune
system aren't mature for *years* and depend on the immunities and high-quality fats from their
mother's milk.
Lynnette Hafken, MA, LLLL, IBCLC
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Date: Sat, 28 Jan 2006 11:11:35 EST
Reply-To: Lactation Information and Discussion
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From: Nikki Lee <[log in to unmask]>
Subject: Re: informal milk sharing
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In a message dated 1/28/2006 10:19:02 AM Eastern Standard Time, AnnMBP
writes:
Nikki, and others, I ask this question: with your worries of informal milk
sharing how many mothers are breastfeeding their own children with HIV or
HTLV-1?
Dear Friends:
Ann poses a good question. I am sure the answer is yes, that there are
women breastfeeding with these viruses. And there isn't anything we can do
about it. And that is one reason that donor milk is pasteurized.
However, when we, as healthcare professionals and knowledgeable people,
are asked our opinion, we have to consider the minimum standards of safety in
our answer.
Can you imagine how breastfeeding in the US would be set back if one
case of serious disease is linked to informal milk sharing?
Lawrence and Lawrence discuss this issue; if mothers want to share milk,
they are advised to get blood tests, and no healthcare professional can be
the agent of arrangement.
Would you use your best friend's toothbrush? Or her husband's?
If not, then how could one share milk without some precaution? At a
microbiological level, there isn't much difference.
warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Maternal-Child Adjunct Faculty Union Institute and University
Film Reviews Editor, Journal of Human Lactation
www.breastfeedingalwaysbest.com
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Date: Sat, 28 Jan 2006 17:31:09 GMT
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From: Melissa <[log in to unmask]>
Subject: Speaking of sharing
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Someone on our local freecycle list just offered 1/2 open can of Nutriga=
men that's been open since the 2nd/3rd week of December. Can you imagin=
e?
Melissa Vance, JD, LLLL
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Date: Sat, 28 Jan 2006 12:01:12 -0600
Reply-To: Lactation Information and Discussion
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From: Kathy Eng <[log in to unmask]>
Subject: Reglan and domperidone question
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What I would want to know first is the basic things like:
1. what kind of pump is mom using (hopefully a rental one)
2. are the flanges large enough?
3. how many times in 24 hours does mom pump?
4. how many times in 24 hours does mom nurse the baby with or without
the SNS?
Many moms are on the wrong pump and are using too small of flanges. And
they get tired and only pump 5 X in 24 hours, dropping their supply. She
might do better nursing more often to get the hormones stimulated. And I
would question the dose of reglan she is on. I am not an MD but it
sounds too low according to Hale, etc.
Kathy Eng, BSW, IBCLC, Houston, TX
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Date: Sat, 28 Jan 2006 13:35:25 EST
Reply-To: Lactation Information and Discussion
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From: Cheryl Taylor White <[log in to unmask]>
Subject: Duration of Breastfeeding
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I think that the issue is less of what is appropriate than what is not.
I refer more often to premature weaning than I do to any specific
length of time for breastfeeding. If I do have to address breastfeeding
in such terms, I usually simply say "normal breastfeeding". I cannot
imagine a perfect word, b/c from our frame of reference, we take for
granted that breastfeeding happens until it is finished happening. How
do we convey this to someone who has a whole other frame of reference?
Jennifer Tow, IBCLC, CT, USA
And in your practice in the US, do you refer to premature weaning as prior
to one year or two years?
Cheryl Taylor White, CBE
_www.drjaygordon.com_ (http://www.drjaygordon.com)
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Date: Sat, 28 Jan 2006 14:08:53 -0500
Reply-To: Lactation Information and Discussion
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From: Stacy Brown <[log in to unmask]>
Subject: two maids a milking
Just a clarification. Two Maids a Milking, A Mothers Milk Bank in
Encinitas is not a collection depot. It is licensed by the State of
California as a milk bank, We have no affiliation with the National Milk
Bank.
Stacy Brown
Two Maids a Milking
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Date: Sat, 28 Jan 2006 14:11:06 -0500
Reply-To: Lactation Information and Discussion
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From: "Catherine Watson Genna, IBCLC" <[log in to unmask]>
Subject: Re: Relationship between excessive foremilk intake and digestive
disturbances
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Perhaps the "epidemic" of GERD is due to our intermittent feeding
pattern in industrialized nations. I wonder if in societies where family
life and work are more integrated and babies breastfeed much more often,
and are largely worn on their mother's body, if GERD is such an issue.
Catherine Watson Genna, IBCLC NYC
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Date: Sat, 28 Jan 2006 14:21:30 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Terri Lear <[log in to unmask]>
Subject: Appropriate terminology for breastfeeding
Perhaps it's up to us (lactation professionals) to start calling
breastfeeding that lasts anytime less than 2.5 years "limited duration
breastfeeding." That way, 2.5+ years may begin to be considered
the "norm" while anything less is considered "limited" or "restricted"
duration. Just a thought.
Terri Lear, BA, IBCLC
Breastfeeding Solutions, LLC
Alexandria, VA 22315
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Date: Sat, 28 Jan 2006 14:41:57 EST
Reply-To: Lactation Information and Discussion
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Subject: Two Maids...
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Stacy says,:
<<Just a clarification. Two Maids a Milking, A Mothers Milk Bank in
Encinitas is not a collection depot. It is licensed by the State of
California as a milk bank, We have no affiliation with the National Milk
Bank.>>
I guess I was confused by your previous post. So you aren't helping mothers
collect milk for Prolacta?
Are you a member of HMBANA? Do you pasteurize and screen the milk there on
the premises? I just can't imagine how much work that must be for the two of
you. Wow.
Do you charge the mothers for the milk they need, or are you a not for
profit organization like the other milk banks such as the Austin Mother's Milk
Bank? How far will you send the milk if a mother needs banked donor milk?
We certainly need more milk banks in the U S!
It is interesting that you are one of the 4 California milk banks listed on
the NMB website.
Guess I'm just not understanding the relationship between NMB, Prolacta,
HMBANA, and the 5 milk banks listed on the NMB site -- none of which are on the
HMBANA website. Maybe you could explain a bit more how this whole thing
works.
Jan Barger, RN, MA, IBCLC
Wheaton IL
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Date: Sat, 28 Jan 2006 14:55:39 EST
Reply-To: Lactation Information and Discussion
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From: Nikki Lee <[log in to unmask]>
Subject: new product comments
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Dear Friends:
Last night I saw a mother who was using a Playtex 'Embrace' pump. I had
never seen one before; it is obviously modeled on the Pump in Style. The pump
flange/collecting bottle looked identical to the Hollister version. It had
the same white wedge valve, and clear plastic. Has Hollister been involved
with Playtex at all?
I just received a free sample of a new "revolutionary feeding system",
called the Second Nature. "The top of the silicon nipple is flat, and is a
thin membrane with 25 holes." Supposedly the force of the baby's suck will
increase the flow; the bottle does not flow when held upside down.
Any one have any experience with this?
warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Maternal-Child Adjunct Faculty Union Institute and University
Film Reviews Editor, Journal of Human Lactation
www.breastfeedingalwaysbest.com
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Date: Sat, 28 Jan 2006 15:29:51 -0500
Reply-To: Lactation Information and Discussion
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From: "Lynnette Hafken, IBCLC" <[log in to unmask]>
Subject: Re: informal milk sharing
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Nikki Lee writes:
> Would you use your best friend's toothbrush? Or her husband's?
> If not, then how could one share milk without some precaution?
> At a
> microbiological level, there isn't much difference.
>
This is a good analogy. However, the choices are to either use your
best friend's toothbrush, or a cow's toothbrush. The cow's
toothbrush has been known to occasionally cause both mild and serious
illnesses and will not get your teeth as clean. The friend's
toothbrush has theoretical risk.
It is definitely chilling, however, to think about how breastfeeding
and human milk would be blamed if there were ever one case of a baby
contracting a virus from shared milk. I wish so much that banked
human milk were readily available to every baby, so we wouldn't even
need to worry about this!
Lynnette Hafken, MA, LLLL, IBCLC
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Date: Sat, 28 Jan 2006 13:32:51 -0800
Reply-To: Lactation Information and Discussion
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From: Ellen Steinberg <[log in to unmask]>
Subject: Relationship between excessive foremilk intake and digestive
disturbances
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Thanks, Ann, for your response. Unfortunately, here in the US we live in a
pill-popping society where going to the doctor is often rewarded with a
prescription for a pill that can be a magic bullet for whatever ails you. I
also deal with many babies who are on meds for GERD. In addition, I speak
with too many moms who are taking fenugreek, mothers milk tea, reglan, etc
but not breastfeeding and/or pumping enough for those things to make a
difference. Taking a pill is certainly much easier than working hard on
breastfeeding or finding the time to pump.
I would welcome any research that is done on the relationship between
overfeeding (breastmilk and/or formula) and GERD. I also think that we are
seeing many babies, both premature and full-term, with digestive
disturbances because of mixed feedings. And these babies are also being
diagnosed with GERD.
============================================
Ellen A. Steinberg, RN, LCCE, IBCLC
E-mail: [log in to unmask]
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Date: Sat, 28 Jan 2006 15:59:08 -0600
Reply-To: Lactation Information and Discussion
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From: Lynn Carter <[log in to unmask]>
Subject: Maids a Milking
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On Jan 26, 2006, at 11:05 PM, LACTNET automatic digest system wrote:
>> The milk that is donated is not used for research
>> for therapeutics for adult disease.
What research *is* it used for?
Lynn in MO USA
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Date: Sat, 28 Jan 2006 17:38:59 -0500
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From: Diane Wiessinger <[log in to unmask]>
Subject: limited duration
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>Perhaps it's up to us (lactation professionals) to start calling=20
>breastfeeding that lasts anytime less than 2.5 years "limited duration=20
>breastfeeding." =20
Ooh, I *like* that. Especially when we're speaking in general terms. =
I'd go for something gentler with a mother herself; just today in the =
grocery store I saw a past LLL mom who "confessed" with mixed pride and =
embarrassment that her daughter nursed to 2 1/2. Those moms, in this =
culture, deserve high praise. But when we speak generally, or to other =
professionals, or in publications, there's the biologically normal =
range... and there's limited duration :-)=20
Diane Wiessinger, MS, IBCLC Ithaca, NY USA
www.wiessinger.baka.com
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Date: Sat, 28 Jan 2006 17:32:23 -0600
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From: Diane Perrone <[log in to unmask]>
Subject: Request for Esther's list
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I have a need for your list for a presentation that is upcoming. I
would appreciate receiving it.
Diane Perrone, RNC
Materna Wellborn
Algonquin IL US
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Date: Sat, 28 Jan 2006 19:22:42 -0500
Reply-To: Lactation Information and Discussion
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From: Ali Crehan Feeney <[log in to unmask]>
Subject: Ants inducing lactation?
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In this article about an Australian rainforest, there is this bit:
<<Not far from my cabin-like villa, Keely stops at a tree trunk to show us
the green ants.
"A good source of Vitamin C," she says.
Bizarrely, they were also used by aboriginal women who, by putting a paste
of crushed larvae on their chest, were able to breastfeed - so they could
look after someone else's child.
"Even grandmothers," Keely says.>>
Does anyone know more about this? I'm fascinated!
The complete article may be found at:
http://www.thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Artic
le_Type1&c=Article&cid=1138191107831&call_pageid=970599119419
---------------------------------------------------------------
Ali Crehan Feeney
Breastfeeding counselor for WIC
Quincy, MA
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Date: Sat, 28 Jan 2006 21:21:50 EST
Reply-To: Lactation Information and Discussion
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From: Kathy Boggs <[log in to unmask]>
Subject: excessive foremilk
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Joy states, "I certainly agree that latch is important, but I maintain that
you
can have oversupply, with too much milk too fast, with a perfect
latch."
I have to agree with you Joy. I believe that most oversupply is biologically
determined. I've worked with many mothers pumping for premature or sick
infants. Those with oversupply can get away with a lot. They sometimes pump 3 or
4 times per day and get 10 oz. each time. A mother with biologically
determined "normal" supply will quickly decrease milk supply if she decreases her
pumping or feeding frequency. A mom with oversupply can have a very difficult
time ramping down. I just saw a mother today who is 2 days post partum. Baby
is gulping at the breast, clicking to slow the flow and spitting up
frequently after breastfeeding. She had oversupply with her first baby. That little
girl gained almost 2 pounds in the first two weeks. This had nothing to do
with latch, just too much milk. Although I seldom try to bring down supply in
the early days post partum I've recommended that this mother feed on one
breast per session and burp the baby in the middle of the feeding and I'm sure
we're going to have to get more aggressive than this to manage her supply.
I also agree that too much milk too fast can cause babies to have GI
distress. We might not feel well if we slugged our whole meal down in 4 minutes
(although nurses are pretty good at that). I also see many more babies of moms
with oversupply exhibiting reflux issues. It makes sense to me that over
filling the stomach too fast with too much milk stresses the sphincter and these
babies may develop significant reflux.
Kathy Boggs, RN, IBCLC
Mountain View, CA
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Date: Sat, 28 Jan 2006 21:46:42 -0500
Reply-To: Lactation Information and Discussion
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From: Mary <[log in to unmask]>
Subject: Hospital outpatient LCs in South Carolina
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I am starting a new LC position at the hospital where I work. I will be
doing outpatient consults along with inpatient. We are interested in finding
out what other hospitals in South Carolina are charging for this service.
Could someone please e-mail me privately and let me know a ball park figure
for this?
Thanks,
Mary
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Date: Sat, 28 Jan 2006 21:12:57 -0600
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Subject: Re: new product comments
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Hi, Nikki,
I received one of these, also, and imagine that most ILCA members or
whatever list the mfgr. bought will receive one. I didn't care for the
slogan about "the perfect design, so they patented it". The thing that I
would be concerned about with this teat is that it has a 'squared' end, =
vs.
domed end. I was concerned that the edge could be very irritating to a
baby's palate, over time. What do you think? I took a few swigs with it. =
It
doesn't shoot out like most bottles. My 8 year old promptly absconded =
with
it, and after she used it, the "micro" holes tore. Of course, that =
wouldn't
be normal wear and tear with a baby :-)
I've become such a fan of paced feeding, that really anymore, the =
cheapest
nipple will usually work.I am not a fan at all of Avent's nipple. I =
think
that is such marketing hype. Babies tend to close on the narrowest part =
of
the teat with the purse-string mouth. To get to the flange, the long =
teat is
crammed down their throats, and the milk squirts out with compression of =
the
base. The shortest teat possible would look more like most moms. =20
Anyone else used this with a baby yet?
Anna Swisher, MBA, IBCLC
Abundant Blessings
Austin, Texas
=A0
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Date: Sat, 28 Jan 2006 20:13:38 -0800
Reply-To: Lactation Information and Discussion
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Sender: Lactation Information and Discussion
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From: Dianne Oliver <[log in to unmask]>
Subject: Reflux
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Hi All,
I've been reading many of these posts regarding oversupply and diagnoses of
reflux with interest. I, like so many of you here in the U.S., are
all-too-aware of our culture's acceptance of the "diagnosis du jour" and
demand for the quick-fix to a health-related concern.
Reflux does seem to be the diagnosis du jour these days in the young
babies. I'm very happy that wasn't the case back when I was nursing my
first son (who's now 13), because we might have been lumped into the GERD
category (had I consulted w/a doctor and not LLL!).
My son threw up (and I do mean *threw up*) every feeding with the exception
of few for the first two, if not three months of his little life. He would
nurse like gangbusters, sputtering, etc. and come off the breast and then
within a minute or so (or less), throw it back up. It was this situation
that drew me to LLL for answers. He gained a pound a week for the first
few months, which was very surprising to me at the time given that it
appeared that he was throwing up all he had taken in! (a testament to how
quickly and efficiently breastmilk is assimilated) I learned to carry bath
towels everywhere and cover all surfaces before we nursed. He was
perfectly healthy, growing, thriving, etc., but I can't help but wonder if
this wouldn't be classified as a case of GERD today.
Basically, I just worked w/gravity as best as possible after feeding and
was careful *not* to burp unless it seemed truly necessary. Ultimately,
time, development, and balancing of intake/production made this scene a
non-issue after several months.
~Dianne Oliver, IBCLC
Simi Valley, CA
______________________
Holistic Lactation
www.holisticlactation.com
805-582-2058
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