Regarding Teri's question on Depoprovera-I was just doing an independent study module from ILCA regarding medications in lactation by Dr. Tom Hale who've I seen posting on Lactnet. The module stated that Depoprovera & Norplant are not contraindicated in lactation & may even increase milk supply-perhaps Dr. Hale could respond on Lactnet regarding this & any new findings. Debi Savage RN, BSN, SNM(soon to be IBCLC) from Westmont, IL re they disorganized because of the method of feeding, or were thaey that way before they were fed? That is the question. We must learn to look more closely at these babies so as to "first do no harm" There is no doubt that LCs are in a therapeutic position to need tools to help rectify babies' sucking difficulties. There are many tools available to help us do this. We need to consider which tool/intervention is going to achieve the goal of getting baby organized and effective enough to do a good job at breast, in the shortest period of time possible, without stressing the baby out , or the rest of the family, in the process. i believe we must make our choice on a case by case basis and not think that one way or another is always the right way. Bottles may very well be the best method in a particluar circumstance, cup feeding in another, and finger-feeding in another. No matter what, the method chosen should have as an end result a baby who goes back to breast and is able to stay organized and transferring milk well. Alison K. Hazelbaker ------------------------------ Date: Sat, 1 Jun 1996 11:02:36 -0400 From: "Alison K. hazelbaker" <[log in to unmask]> Subject: Re: Frenuloplasty Catherine, could you please describe a frenuloplasty? TIA Alison K. Hazelbaker ------------------------------ Date: Sat, 1 Jun 1996 10:23:34 -0500 From: TERI RICHARDS <[log in to unmask]> Subject: Introduction Hello, my name is Teri Richards. I'm a labor/delivery RN in a small hospital 20 miles from Madison, WI. I'm currently doing the home study program to be a lactation consultant, (on lesson 7). I have 3 daughters, Holly 7, Laurel 3, and Leah 9 mo. (I'm nursing her currently) I'm excited that I have finally subscribed to Lactnet. We have only had our computer 2 weeks. Soon, I'll be a breast pump rental station also. I look forward to reading Lactnet daily now! Teri Richards,RN [log in to unmask] ------------------------------ Date: Sat, 1 Jun 1996 11:37:22 -0400 From: "Jane Crotteau BSN, RNC, IBCLC" <[log in to unmask]> Subject: Exposure to Hazardous Materials A client called me with an interesting problem. She has a 7 month old Bf baby and works for a large corporation. During her pregnancy and up until now shw has not had to work with any chemicals and now they want her back where she worked before her pregnancy. They have told her that she has to prove that these chemicals may be dangerous to her nursing infant. She called her pediatrition and he referred her to us. She gave me a packet of 'HAZARDOUS CHEMICAL DATA SHEETS' about two inches thick and I have no idea how to find this information. Any Ideas?!? Thanks, Jane. ------------------------------ Date: Sat, 1 Jun 1996 12:29:20 PDT From: "Barbara Leshin-Zucker, IBCLC" <[log in to unmask]> Subject: Employment and LCs It has been a long time since I have been on lactnet. We have a new carrier and I have had lots of trouble logging on-but finally figured it out and am excited to be recieving mail again. (Although my son made a comment like-"Oh, no! Mom's getting Lactnets again. Now no one will be able to get near the computer) To make a long story short, I am an LC in Orange County, NY and have been had 2 part time jobs over the last 5 years in a hospital and with a WIC agency. In December, the hospital experienced some bugetary problems and, seeing the handwriting on the wall, I left that position-although I discovered I was to be terminated anyway. I found out a few weeks ago that, also because of serious budget difficulties, my position at WIC will also be ending as of June 20th. Needless to say, I am very upset by all of this and would love to hear others ideas on how to continue to make a living in the field of lactation. Although my supervisor at WIC is desperately looking for a grant (anyone out there know of any?) I am fearful that I may need to go it on my own. Of the many LCs I have spoken to, I don't know any who is making enough money to get by. Having 3 of our 5 children in college next year makes income a necessity!! Anyone out there have any insight on either jobs in lower NY State or other ideas. Although I am not a nurse, I come well recommended by my supervisors. I am only afraid that my time in the field of lactation is over and since I have been doing this since 1986, I have very few ideas on how to proceed. You can email me privately, rather that take up room here. If anyone else wants to know what I come up with, email me and I'll share any information I recieve. TIA for your support and Ideas. Barbara Leshin-Zucker, IBCLC Highland Mills, NY ------------------------------ Date: Sat, 1 Jun 1996 13:44:26 -0400 From: ROGER SIPRESS <[log in to unmask]> Subject: DEPOPROVERA Hello, out there. I'm Terry Sipress, BFA,ICCE,IBCLC. I've been reading the postings with fascination for several weeks now and loving it, though I wish I had more time. About me: I have a husband, Roger, who supports me through my various and many endeavors; a son, Matthew who is a dancer, singer, actor fresh off a tour and broadway run of Hello Dolly and is soon to head off to summer stock in Hampton Beach(?),NH; and a daughter, Abby who is a student at York College of PA. This year it's a Mass Communications major, last year it was music...who knows. To the point:I work as a childbirth educator (mostly) and LC in a hospital clinic. During classes we review birth control methods and, per everything I've found in the literature, discuss hormonal methods possibly reducing milk supply. I usually present pros and cons and leave it that anyone who really wants to use a hormonal method should at least wait until 6 week checkup when breastfeeding. Yesterday I spoke to one of my students who delivered last week. Prior to delivery she'd decided on depo at the pp checkup, but informed me that she'd had the shot in the hospital because the Doctor told her it would help her milk come in! I have only seen reports to the contrary, so is there something out there that I'm missing? If anyone has any info on this, please reply. Fortunately, this mom did,in fact, have an abundant supply. She told me she was glad she had her pump from her firstborn because on day 3 she got engorged and pumped 4 oz. in 5 minutes. TIA, Terry ------------------------------ Date: Sat, 1 Jun 1996 15:49:58 -0400 From: "Marie Davis, Rn, Clc" <[log in to unmask]> Subject: Jan Barger's two cases Jan, Case one: If it's an allergy maybe mom can try putting some of the cream on the tender skin inside her elbow on one side and some of the formula on the other. It's called a patch test and if it's a contact dermatitis she show some symptoms on the arms. I had a case like this a while ago. (I posted to lactnet) In that case it turned out that it was a combination of contact dermatitus, thrush and secondary bacterial infection. It was a real mess. The dermatiologist also had questions about the pH of the baby's saliva. Unfortunately this mom gave up. Case two: First, try to get the baby to forget about the breast for a day or two. Maybe mom's been trying too hard and the kid is "breast-phobic." Look for tortocollis, fractured clavical, sores in the baby's mouth anything that might cause the baby pain. I had a little guy once who would scream everytime he just saw the breast--he had a fracture clavicle. Mom was finally able to get him to the breast by first holding him against her bare chest without asking him to nurse. Then she tried sitting him in a car seat and leaning over him to breastfeed--it worked. She figured if the broken collar bone hurt when she held him, maybe if she didn't hold him he might be willing to nurse. (really inventive mom) She eventually was able to pick him up to nurse but it took a few weeks. I'd also look at the tension level of the mom. When the mom tries to latch the baby on--you hold on to mom. Is she tense? Do her muscles feel tight to you, especially in her forearm or hand? Sometimes these babies pick up on the muscle tension in the mother and "wig out" If you get the baby relaxed and you latch him on (without letting mom touch him) what happens? If the baby seems hyper sentitive all over--can't stand to be undressed, panicks at movements, etc-- then maybe brush therephy and massage will help. If mom is too loose or awkward, then maybe she needs to be shown how to make the baby feel more secure in her arms. (I've seen both ends of the scale with this) Once this little kiddo has forgotten about the breast I would try gentling back to the breast and re-birthing. Good luck, Marie Davis Moreno Valley, CA ------------------------------ Date: Sat, 1 Jun 1996 16:30:42 -0400 From: "Digest Laurie Wheeler, Rnc, Mn, Ibclc" <[log in to unmask]> Subject: normality of bf In a message dated 96-06-01 11:06:19 EDT, you write: >Subject: NORMALITY OF BREASTFEEDING > >I could not resist sharing one anecdote from my trip (a few years back) to >Nairobi, Kenya. During a brief respite for assessing hospitals, we visited >a local market. People were milling around all the little stalls where >people were selling all kinds of things (I got a large woven bag there). I Re Nairobi, KA writes: > I was the ONLY one who appeared to notice a mother who lifted a breast from >her dress (through the scooped neck in front) and allowed her BIG nearly >toddler baby (I estimated about 11 mo old) to suckle. No one else batted >an eye How lovely! This is my dream for the US and everywhere. And if the little one reached in for the breast or raised Mama's shirt, I'm sure that wouldn't be noticed either. Laurie Wheeler ------------------------------ Date: Sat, 1 Jun 1996 16:30:46 -0400 From: "Digest Laurie Wheeler, Rnc, Mn, Ibclc" <[log in to unmask]> Subject: 6 wk premies/low supply Sharon Coe, Re the mom with the low supply and the 6 wk premie twins - you seem to have just about all the bases covered. I would add that putting her in touch with another/other mothers who have been thru same would be very helpful, esp. success stories. Perhaps you know of others, or the NICU staff will, or the local LLLL. She may not want to go to LLL meetings, as she may feel out of place, altho she would be welcomed. She probably needs to ventilate, as to how hard it is, how sick the kids are, will they ever bf, etc. Lots of listening and validating what she is going thru. You are right that she should pump more - but whatever she can accomplish is OK - I would approach it something like "it must be so hard to work those long hrs, then go to see the babies, and still trying yourself to recover from the births, etc" "Do you think you could add a pumping session during the week or weekend?" (even adding one daily may be too much). Hope this helps, Laurie Wheeler, Rnc, Mn, Ibclc Former NICU Nurse/BF Counselor >r ------------------------------ Date: Sat, 1 Jun 1996 17:06:36 -0400 From: Marge Collier <[log in to unmask]> Subject: introduction-new member Marge Collier I am a Medical Technologist MT (ASCP) and have worked in clinical microbiology, hematology and chemistry before doing education and administrative work in that field. I also have a Masters in English. I 'm working very hard to educate myself as an LC through conferences, attending ILCA etc.and hope to be certified in the future. I have worked for myself for the last 3 years--in my "BF specialty store." I am excited about being on Lactnet and anticipate learning a lot and I hope that I may be able to share some knowledge about how clinical lab work, results or assays sometimes impact on lactation. My children are 14 and 3--the younger of the two is a nursing toddler! ------------------------------ Date: Sat, 1 Jun 1996 18:15:51 -0400 From: Janet Simpson <[log in to unmask]> Subject: WBFW Theme Hi ALl, Hey, can someone tell me what the theme for World BF Week is this year? It just dawned on me that I don't know! TIA!! Jay ------------------------------ Date: Sat, 1 Jun 1996 18:48:15 +0000 From: Karen Nelson <[log in to unmask]> Subject: Re: WBFW Theme Jay, "BREASTFEEDING: A Community Responsibility." Karen ------------------------------ Date: Sat, 1 Jun 1996 19:50:22 -0400 From: Judie Zersen Ibclc <[log in to unmask]> Subject: Home Made Pacifiers! Hi, I'm Judie Zersen LLLL IBCLC CLE. I have been lurking since Aug 95. Since receiving my certification in 85 I have been in private practice here in the San Pedro, Ca. My children are Todd, 29, born in Anchorage, Bridgetta, 25, born in Charleston SC, and Aaron 21 born in Winter Park Fl. LLL all the way! I had the priviledge of talking to my grandmother extensively about the way she raised her kids at the turn to the century. So when the subject came up here on LACTNET about the pacifiers for breastfed babies, I remembered what my grandmother told me she did for her fussy babies. She called them her "Sugar Tit's". She said she would take a nice clean thin piece of white cotton cloth and put a piece of bread in it with a little sugar or honey and tie it up with string. Then be sure to make it plenty good sized so it would last all day. She said to then dip it in expressed breast milk or water and let the baby suck on it so you could get work done or a long day of travel by horse and buggie or wagon. ( I imagine the babies had to really open their mouth plenty wide to get all that tit in his mouth and then work on elongating it to fit his mouth just right.) She would prepare a fresh one every day. I remember her saying about any fussy baby that she had to endure, " Somebody give that kid a Sugar Tit!" Of course the everybody laughed and were a little embarrassed too. She had a 40 acre farm and 9 children, all now aged between 77 to 93. The children have been strong and healthy with high IQ's and a family that has very close. By the way she was a failure to thrive baby. She only weighed 12# at a year old. Her grandfather got her to start gaining wt by giving her scraped raw apples. I love my time with ya'll. Thanks. Judie Lewis Zersen, [log in to unmask] ------------------------------ Date: Sat, 1 Jun 1996 21:43:05 -0400 From: Karen Page <[log in to unmask]> Subject: Breastfeeding policy I can understand the public feeling uncomfortable about public breastfeeding whether the breast is exposed or not. Remember for the majority of our old and young people ... no one has really seen it. Think about it... it is not on the news, TV, magazines, billboards, movies, kodak moments etc so people are going to stare because it is a new experience. If it was a loving, beautiful moment with mother and child interacting with their heart and soul... I believe all would be in awed. Just yesterday, my neighbor invited my son and I to participate in their home-schooling. During the session my neighbor needed to breastfeed her 3 month old, I have been with my neighbor since the birth of this child and have never seen any exposure. I out of respect, I gaze away and I noticed my son looked over and gazed away also out of respect. My son is 5 years old. Parents are great role models for our children and for other children as well. I like to add this mother has also breastfed at church with no cover, no exposure. I make it a habit to watch others when mothers breastfeed ready to be an advocate if the opportunity occurs. People just do not know how to discreeting watch and learn. I am appalled each time I hear about these concerns, I wish I was there. Just remember since the 17th century the French began the ole tradition of children to be denied the breast that their child would be spoiled. Do you suppose with the march for children safety and protection, breastfeeding could be put on the agenda. Latch onto life.. Karen ------------------------------ Date: Sun, 2 Jun 1996 12:10:19 +1000 From: Lisa Amir <[log in to unmask]> Subject: Re: ?thrush/?dermatitis > Peds prescribed Nystatin (without seeing the baby). .... Her doc puts her on Nystatin cream. Nipples get progressively worse, >as do white patches in baby's mouth. The entire areola is excoriated & weeping >yellow gunk. Bright deep red. Swollen....... Looks like an allergic reaction >-- to the Similac. Is that even possible? Is the juxtaposition of giving >the formula and baby getting white patches just a red herring? (In this >case, a white herring). Could it have started as thrush and then progressed >to something else? It could be an allergic reaction to the preservatives in >the cream, I suppose. >This is a plea to NOT diagnose over the phone! Jan, I agree: nipple problems must be seen, not diagnosed and treated over the phone (or even the internet). Certainly sounds like dermatitis / eczema. Probably a reaction to either the formula or the nystatin, so stop the nystatin and ??change formula. Dermatologist will probably prescibe steriod ointment which should help in a few days. Does the baby still have oral thrush? Did the baby really ever have thrush? Sometimes one has to treat thrush and dermatitis at the same time. But in this case the diagnosis of thrush is still unsure isn't it? Lisa Amir GP / LC in Melbourne, Australia ------------------------------ Date: Sat, 1 Jun 1996 22:47:56 EDT From: "Melissa L. Brancho" <[log in to unmask]> Subject: Statistics on IBCLC Participation I was sitting here thinking about things when I am supposed to be thinking of other things and was wondering if there was a statistic available on what % of IBCLC is represented on Lactnet? I am restricting this stat to IBCLC's because I figure they are the easiest to find numbers for. If you tried to find out the number of IBCLCs and other LC types and LLL for example, it would be very difficult esp if you don't have the overall numbers for each of these groups. So does anyone have any clue as to what % of IBCLCs are on Lactnet? Kathy A or B? Melissa Brancho ------------------------------ Date: Sat, 1 Jun 1996 23:30:07 -0400 From: "Paula J. Ray, RNC,IBCLC" <[log in to unmask]> Subject: budding Lactation Consultant Just a " Life with Children Note " , My Beagle has had a litter of 4 very beautiful baby puppies. The short version is that one required suture repair of a leg injury (Ms. Scarlett ) and could not be left unattended to feed, another ( Little Lonesome ) had no suck, or desire to feed. So, LC mom was "assisting " one to teat, and tube feeding, then finger feeding the other until her suck kicked in.....Several days after everyone was eatting well on their own, my 6 year old daughter came into the kitchen with her hands on her hips, in her very serious mode, and announced " Lonesome wasn't eatting again, but its ok, I latched her on and she is nursing fine now..." Could I be accused of slightly prejudicing her ?? :) Growing the Next Generation of Lactation Consultants... Paula J. Ray RNC , IBCLC Longview, Texas ------------------------------ End of LACTNET Digest - 1 Jun 1996 - Special issue **************************************************