I just got off the phone with a nurse who is in our lactation program at her
workplace. Baby was born in January. This is her 2nd breastfed baby. She
signed up for the Ross program while pregnant in order to see what they
sent, but the shocker in our conversation is that on Christmas morning, at
830 am, she had a special delivery package of formula from Mead Johnson.
What we can't figure out, is how MJ got her name! I'm sure that the Ross
folks didn't sell her name to MJ, she goes to an HMO and we can't believe
they are providing names to formula companies, and the baby wasn't born yet
so they didn't get it from the birth certificate people. Good news is that
at one month baby is totally breastfed and mom gave the formula to the
hospital nursery.
Jacie in loverly Albuquerque, New Mexico!
=========================================================================
Date: Sat, 6 Feb 1999 18:51:00 -0600
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Susan R Potts <[log in to unmask]>
Subject: Nipple Shield Use
MIME-Version: 1.0
Content-Type: text/plain
Content-Transfer-Encoding: 7bit
Another post on nipple shields. During my 16+ years as a pp nurse I
HATED nipple shields. Our unit stocked those old terrible rubber 21/2
inch long kind, and they were pulled out by a couple of offenders (catch
the br feeding crime thread?) routinely to solve any breastfeeding
problem. They NEVER solved the problem, only made more, and if I had a
mother using one for my patient I always gently steered her away from the
shield and helped the baby latch on without it.
While attending the 5 day UCLA class I saw the thinner, smaller
silicone shield. And the JHL edition on nipple shields really made me
take a second look. I have concluded that they can be useful for some
mothers, and though perhaps while I am with her I can help the baby
latch on, I won't always be there, it will be another nurse or the mom on
her own. The lactation program at my hospital has been up for about 18
months now and our policy is that any mom discharged using a nipple
shield will return with the baby for a weight check within 2-3 days and
then weekly as needed. The moms are informed this is because of the
chance of lowered milk supply or lowered milk transfer with the use of
the shield, they are also told the shield is usually a temporary measure
to be used for a few days, weeks, or months. We are developing a
consent/teaching form. We keep the shields in our locked LC supply
closet. So far we have had about 10-12 moms using a shield and not one
problem with a baby's weight gain. Only one mom used the shield for
months and is still using it, and avoids the one LC who was pushing her
to get off of it.
Recovering from end-of-vacation, back-to-work shock, after a
lovely week skiing with dh and the kids and hot tubbing/swimming every
night. My genius hubby threw 5 snowsuits and assorted cold weather gear
into a huge clean plastic trash can, put it into the minivan and away we
went, just to Wisconsin, but sure was fun. We also achieve genius status
at our house by the suggestion to order a pizza!!
Susan Potts RN IBCLC Minnesota
___________________________________________________________________
You don't need to buy Internet access to use free Internet e-mail.
Get completely free e-mail from Juno at http://www.juno.com/getjuno.html
or call Juno at (800) 654-JUNO [654-5866]
=========================================================================
Date: Sat, 6 Feb 1999 17:48:22 -0800
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: stu and jan black <[log in to unmask]>
Subject: Thyroiditis
Mime-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
Excuse me if I missed some of the background info here.
Did this Mom have Thyroid levels done?
When my Son was about 6 months old I crashed into a very painful and life
changing PPD. I went from Dr to Dr searching for a diagnosis for my
palpitations, extreme panic attacks etc and one did come up with
"Thyroiditis" with no testing (can you test for this or only based on
symptoms?).
And yes, PPD can be diagnosed as long as 2 yrsafter.
One Psychiatrist insisted I was not depressed, and should begin Betablockers
for my palps. I suffered for a long time and hope this Mom is getting the
right diagnosis.
Respectfully,
Janet Black RN
Breastfeeding Counsellor
Mission BF Support Services
=========================================================================
Date: Sat, 6 Feb 1999 20:10:41 -0600
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Susan R Potts <[log in to unmask]>
Subject: Nipple shield use (again)
MIME-Version: 1.0
Content-Type: text/plain
Content-Transfer-Encoding: 7bit
One more comment: With the use of the nipple shield, at least the
feeding problem is being treated at the breast. Some mothers would
choose bottle feeding without it.
Susan Potts RN IBCLC
___________________________________________________________________
You don't need to buy Internet access to use free Internet e-mail.
Get completely free e-mail from Juno at http://www.juno.com/getjuno.html
or call Juno at (800) 654-JUNO [654-5866]
=========================================================================
Date: Sat, 6 Feb 1999 20:41:17 -0600
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Christine A Raasch <[log in to unmask]>
Subject: Allergies & BF Story (long)
MIME-Version: 1.0
Content-Type: text/plain
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1. Allergies, I have a G2 P1 mom who will be delivering 3/5/99 via
repeat C-S. Her first child has severe allergies to milk, fish, eggs and
nuts. The child has anapylactic reactions to eggs. Mom wants to do all
she can for this child to avoid allergies. I asked her to stop elimiante
any dairy products from her diet, although her child allergist didn't
feel this is necessary. Would you have this mother also eliminate eggs,
fish and nuts from her diet? Mom has a Rice product she uses but I can't
remember the name right now.
2.Wanted to share this story with folks who can really appreciate the
benefits of breastfeeding. We had a full term male infant delivered
Wednesday afternoon. Mom, a primip, was bottle feeding. By 10PM, the
baby had barely taken 3/4 oz of formula. When I came to work on Thursday
(I also work as a case manager), I was informed that the baby had not
retained any feedings, regardless of the formula. We sent my daughter to
the store to buy a P_____Nurser because the mother told us her sisters
baby also had this problem and it was solved with the P______ Nurser.
Well, our baby gagged with this bottle nipple also.
I suggested that we try cup feeding, but after seeing the baby suck
without difficulty on the mothers finger, I suggested finger feeding.
While the nurse caring for this Mom/Baby couplet was out getting the
feeding tube, I asked the mother if she had ever considered breastfeeding
her baby. As I was asking the mother, who was cradling the baby in
her arms, this little boy turned his head completely toward me as if to
say, "that's right, I want to breastfeed!" She told me she would if it
would help her baby.
Although my colleague informed both mother and myself that breastfeeding
wouldn't make any difference, we decided to give it a try after the baby
gagged with finger feeding each time the feeding tube was introduced. (I
suspect that it was the larger bolus of food that was affecting the
baby.) The baby went to breast and nursed well, then went to sleep.
After 24 hours of no feedings, the baby fed on demand for the next 24
hours, started voiding and stooling and was quite content. Mom, who is a
red head, and we all know what that's supposed to mean, had intact
nipples, no evidence of poor positioning. I pray she will continue - she
was quite proud of herself.
Thanks for the opportunity to share my long story -
Christine Raasch, RN, IBCLC
Menomonee Falls WI
[log in to unmask]
___________________________________________________________________
You don't need to buy Internet access to use free Internet e-mail.
Get completely free e-mail from Juno at http://www.juno.com/getjuno.html
or call Juno at (800) 654-JUNO [654-5866]
=========================================================================
Date: Sat, 6 Feb 1999 22:18:07 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Katie Allison Granju <[log in to unmask]>
Subject: Help! Need average BFing duration info, ASAP
Mime-Version: 1.0
Content-type: text/plain; charset=US-ASCII
Content-transfer-encoding: 7bit
Can anyone provide me with the names of four or six countries/cultures around
the world in which the current average age of weaning exceeds two years?
Three years?
Thanks--
Katie
Katie Allison Granju
Knoxville, TN
http://www.wearsthebaby.com/katiegranju.htm
=========================================================================
Date: Sat, 6 Feb 1999 23:04:44 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Jane Ciaramella RNC, IBCLC" <[log in to unmask]>
Subject: Re: Breast Abscess
Mime-Version: 1.0
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I saw a Mom on Friday who was diagnosed with a breast abscess 2 days prior to
when I saw her. She came to me to discuss the possibility of continuing to
breastfeed even with abscess. I have limited experience with this condition so
most of my knowledge is book knowledge in this respect. I shared with her the
section in The LLL Answer Book, Auerback, and The Breastfeeding Counseling
Guide in order to give her more information with which to make an informed
decision. She expressed a strong desire to continue to BF her 3 month old baby
who was even having allergic reactions on breastmilk only. He had had episodes
of blood in stools and Mom had done lots of diet modifications under the
guidance of her Ped.
The surgeon, who has a very good rep in this area, advised weaning in no
uncertain terms. Mom contacted LLL , and was told she could BF even after I&D.
I basically gave her that same information and we discussed all of her options
of how to continue.
She saw surgeon right after me and the surgeon flat out told her NO! She was
not given a choice! If I was this Mom I would have felt strong enough to say
this is my baby and my decision , thank you for the good job on the I&D and
that's as far as your involvement goes! I tried to encourage this Mom to make
her own informed decision given the information in the literature but I felt
like she was bullied into thinking her own health would suffer irreparably if
she did not wean.
I even talked about BF from one breast as a last resort. She was too teary to
talk at that point.
Any comments, ideas on what I could have done differently? I have not spoken
to the surgeon, but would like to? Any research on this?
Any help would be appreciated.
Jane Ciaramella RNC, IBCLC
=========================================================================
Date: Sat, 6 Feb 1999 23:14:10 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Kathleen Bruce <[log in to unmask]>
Subject: abscess
Mime-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
There are many references to bf through abscess treatment, etc, Auerbach and
Riordan, Lawrence, etc. This is common.
I wonder where the reference is that she shouldn't?
Kathleen
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet,TLC, Indep. Consultant
Williston, Vermont
mailto:[log in to unmask]
LACTNET Archives http://library.ummed.edu/lsv/archives/lactnet.html
=========================================================================
Date: Sat, 6 Feb 1999 23:16:29 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Kathleen Bruce <[log in to unmask]>
Subject: archives
Mime-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
The computer at Ummed is currently suffering strain, as you might have
noticed if you try the archives. ( I want to thank everyone who uses them
before they post).
The server at Ummed is going to be replaced ( it is a 486 machine), and we
are going to be switching the list over, some time in the future, date
unspecified.
We are continuing to rely on the good graces and generosity of the Univ. of
Massachusetts Medical School for their donation of server, and staff to run
this list. If anyone wishes to thank those who do this work on our behalf,
please send a note to me and I will give you the address of the persons
involved. They do it for free, and without any payback.
Kind regards, and asking for continued patience..
Kathleen
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet,TLC, Indep. Consultant
Williston, Vermont
mailto:[log in to unmask]
LACTNET Archives http://library.ummed.edu/lsv/archives/lactnet.html
=========================================================================
Date: Sun, 7 Feb 1999 14:15:34 +0800
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Barb Thomas <[log in to unmask]>
Subject: Weaning because of IVF?
MIME-Version: 1.0
Content-Type: text/plain; charset=us-ascii
Content-Transfer-Encoding: 7bit
G'day Lactnuts,
Could I have your collective wisdom, please. A mother I have been
counselling has been told that she has to wean her 17 month old if she
wishes to conceive again. She has re commenced menstruation, so this is
not the issue. She is on an IUI program and they are adamant that she
has to wean. She does not want to wean in case she does not fall
pregnant (the last lot of treatment took 9 months) I have searched the
archives with no luck. Has anyone had any similar experiences? Does this
mum have any choice?
TIA
Barb Thomas
NMAA Counsellor
Perth Western Australia
40 degrees C today..phew!
Mum of Anthony,11 Linda,8 Michael,5 Kirsty 5 months
"blest is the babe, nursed in his mother's arms
who sinks to sleep Rocked on his mother's breast
who with his soul Drinks in the feeling of his mother's eye"
-Wordsworth
=========================================================================
Date: Sun, 7 Feb 1999 14:26:14 +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: nipple shields
Mime-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
>I will, next time this situation appears, feel reassured if the baby
>appears to latch on okay with the shield - when you say the flat part
>wrinkles, do you mean sort of folds back over the baby's upper lip?
Yes, often that does happen. I know some people get all worried about it
blocking the baby's nose, but it is usually OK. Sometimes it doesn't
actually fold back, just wrinkles.
The last mother I saw who was bf with a shield
>w/o supply problems did in fact have this happen. I honestly don't think I
>have been observant enough in the past - I have just thought 'shield - oh
>no'.
I think this is a common response!
>My main concern with shields remains the fact that they are given to help
>with a latching problem, instead of skilled help, and the shields allow a
>*spurious* latching success...the baby has *something* in its mouth and
>gets milk out *somehow* and everyone is supposed to cheer and think all is
>well. It so often is not.
I agree wholeheartedly. That's why I make a big deal about *how* the baby
is attached.
******************************************************************
Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Nursing Mothers' Association of Australia Breastfeeding Counsellor
Perth, Western Australia. mailto:[log in to unmask]
******************************************************************
=========================================================================
Date: Sat, 6 Feb 1999 23:25:45 -0800
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Janet Simpson <[log in to unmask]>
Subject: nursing story...
Mime-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
Thought you all might get a nice little chuckle out of this:
Was nursing PJ (my 2 yr old) this morning. He was playing with a toy
dinosaur. He unlatches and puts the dino to my breast and says "Dino, Milky
Muhs!" and proceeds to gently "bounce" the dino on my nipple! I told him
in no uncertain terms - "Mommy does not give Muhs to dinosaurs." :D
Well, I thought I'd be asked to nurse cars or baby dolls, but not a dino!
Jay
Jay Simpson, CLE
Sacramento, California, West Coast, USA
"No Miracles performed here, just a lot of love and hard work."
=========================================================================
Date: Sun, 7 Feb 1999 15:30:26 +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: Breast Abscess
Comments: cc: "Jane Ciaramella RNC, IBCLC" <[log in to unmask]>
In-Reply-To: <[log in to unmask]>
Mime-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
>I saw a Mom on Friday who was diagnosed with a breast abscess 2 days prior to
>when I saw her. She came to me to discuss the possibility of continuing to
>breastfeed even with abscess.
<<snip>>
>The surgeon, who has a very good rep in this area, advised weaning in no
>uncertain terms. Mom contacted LLL , and was told she could BF even after I&D.
>I basically gave her that same information and we discussed all of her options
>of how to continue.
>She saw surgeon right after me and the surgeon flat out told her NO!
Oh Jane, this poor mum. If having the abscess wasn't enough! We have a
surgeon here, who I heard speak a few years ago about abscesses. He tries
to manage them with repeated aspirations rather than incision & drainage,
but one thing I remember him saying was that he *does not allow the mother
to stop breastfeeding* at least until the whole treatment for the abscess
is resolved. ie the exact opposite to what the surgeon in your area said.
I also looked up what is written in 'Breastfeeding Management in Australia'
- NMAA's book written for health professionals. Here is a quote:
'A true abscess requires surgical drainage as well as antibiotic therapy,
rest and complete emptying of the breast every few hours. (mention of
repeated aspiration)...As the abscess usually remains confined to the
interstitial tissues, milk from the affected side generally remains
uncontaminated. When the surgical incision or drains interfere with sucking
because of their proximity to the areola or if the abscess ruptures into
the ductal system, temporary weaning is necessary. Breastfeeding can
continue on the unaffected side and resume bilaterally as soon as this is
acceptable to mother and baby. (Reference - see below). Not to permit
feeding after surgery greatly increases the chances of poor wound healing
and cessation of lactation. Milk leaking out through the incision may be an
inconvenience, but will not prevent healing.'
Reference mentioned in this section: Banapurmath C et al 1995, Successful
management of breast abscess with ongoing breastfeeding. Indian Pediatr 32:
488-491
And for the repeated aspiration technique: Dixon J 1988, Repeated
aspiration of breast abscesses in lacvtating women. Br Med J 297: 1517-1518
******************************************************************
Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Nursing Mothers' Association of Australia Breastfeeding Counsellor
Perth, Western Australia. mailto:[log in to unmask]
******************************************************************
=========================================================================
Date: Sun, 7 Feb 1999 00:47:30 -0600
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Jon Ahrendsen <[log in to unmask]>
Subject: Re: assault and battery
Comments: To: Phyllis Adamson <[log in to unmask]>
MIME-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
Content-Transfer-Encoding: quoted-printable
My imperfect memory trap of a mind, ( I don't remember everything, but I =
remember alot) recalls an cartoon illustration in an encyclopedia =
showing the difference between battery and assault and battery. (I =
actually located the drawing if anybody really really wants to see it.
If a person swings a club and misses it is assault, if you swing and hit =
it is assault and battery. The encyclopedia (1965 edition) says that =
battery pertains to the blow or other physical injury. It seems hard =
to imagine that a gentle touch of the hand could be construed to cause =
physical injury, especially when the intent was therapeutic. Someone =
might be offended, but physically injured? I doubt it.
Jon Ahrendsen MD ABFP
& Becky=20
parents of Andrea, Elizabeth and Karl
Clarion, Iowa=20
=========================================================================
Date: Sun, 7 Feb 1999 05:24:14 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Nancy E. Wight MD, FAAP, IBCLC" <[log in to unmask]>
Subject: Re: BFing and Dental Health
Mime-Version: 1.0
Content-type: text/plain; charset=US-ASCII
Content-transfer-encoding: 7bit
For an article on breastfeeding and dental health check out:
www.breastfeeding.org and look under articles.
Nancy Wight MD, FAAP, IBCLC
=========================================================================
Date: Sun, 7 Feb 1999 06:34:02 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: newman <[log in to unmask]>
Subject: where they got the name
Comments: To: [log in to unmask]
MIME-Version: 1.0
Content-Type: text/plain; charset="iso-8859-1"
Content-Transfer-Encoding: 7bit
The formula companies have all sorts of tricks up their sleeves. And
everyone works for them. In Toronto, you might sign up at a maternity store
mailing list, and you will be on the formula company mailing list. And the
old standby--some relative or "friend" signs up for you.
Jack Newman, MD, FRCPC
=========================================================================
Date: Sun, 7 Feb 1999 06:39:37 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: newman <[log in to unmask]>
Subject: breast abscess
Comments: To: [log in to unmask]
MIME-Version: 1.0
Content-Type: text/plain; charset="iso-8859-1"
Content-Transfer-Encoding: 7bit
I have seen perhaps 50 mothers with breast abscess over the past 5 years. If
I remember correctly, one or two had already quit, and another 1 or 2 quit
when they heard they had an abscess. All the others were encouraged to
continue breastfeeding, even on the affected side, and did continue. With
no problems for the mother and baby.
It is interesting that the surgeon nixed breastfeeding even on the
unaffected side. I found out that surgeons believe that if you continue on
one side it will stimulate the milk supply on the other. So here we have a
surgeon whose premise is incorrect (that continuing breastfeeding on the
affected side will cause the mother's health damage), and whose physiology
is also incorrect (he doesn't know that breastfeeding on the unaffected side
will not cause stimulation of milk production on the other).
Jack Newman, MD, FRCPC
=========================================================================
Date: Sun, 7 Feb 1999 13:49:43 +0200
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Annelies Bon <[log in to unmask]>
Subject: beta-lactoglubolin
In-Reply-To: <[log in to unmask]>
Mime-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
Doeds anyone know what beta-lactoglubolin is? I'm wondering what the
subject of the following article indicates......
Fukushima Y, Kawata Y, Onda T, Kitagawa M, 1997, Long-term comsumption of
whey hydrolysate formula by lactating women reduces the transfer of
beta-lactoglubolin in human milk (abstract only). J. Nutr Sci Vitaminol
43(6): 673-678.
---
Annelies Bon
Breastfeeding Resources http://utopia.knoware.nl/users/abon/bfbronnen.html
breastfeeding counsellor of the Dutch bf org "Borstvoeding Natuurlijk"
mailto:[log in to unmask]
living in a small city, Almere, near Amsterdam, The Netherlands
=========================================================================
Date: Sun, 7 Feb 1999 09:07:21 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Cher Sealy, LLL Leader" <[log in to unmask]>
Subject: Hives and Vitamins?
Mime-Version: 1.0
Content-type: text/plain; charset=US-ASCII
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A friend of mine is nursing a 2 year old. Last Thursday her little girl broke
into hives. My friend says her child had eaten nothing different from her
usual diet prior to this happening. But Mom had started on a new vitamin the
day before which she got at a health food store. She says there are no
additives--only a multi-vitamin mineral tablet. Mom had also eaten 2 Protein
soy bars from the same health food store. Any ideas on what would be the most
likely cause of the hives? Mom said she quit breastfeeding for 24 hours.
Hives got better. Yesterday she went back to nursing and hives got bad again!
Mom is feeling very guilty! I suggested taking vitamins out of diet, but have
never heard of this occurring as a result of a vitamin supplement.
Thanks for any input!
Cher Sealy, RN, BSN, IBCLC, LLLL
Montgomery, Alabama
=========================================================================
Date: Sun, 7 Feb 1999 09:09:50 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Marsha Walker, RN, IBCLC" <[log in to unmask]>
Subject: Formula Discharge Packs
Mime-Version: 1.0
Content-type: text/plain; charset=ISO-8859-1
Content-transfer-encoding: quoted-printable
I use the following as a handout when I lecture on the hazards of infant
formula. Please feel free to see if there is any idea in this that may be =
of
help to those who are faced with the absurdity of enticing mothers to deli=
ver
at your hospital because they get free discharge packs with formula. The
president of your hospital, its CEO, and its board of directors should all=
be
informed of this practice as well as the hospital's ethics committee.
Ridding Your Hospital
of Formula Dependency
The health care system has traditionally been a major conduit for the
promotion of infant formula use. The medical sanctioning of artificial fee=
ding
of infants starts at obstetrical visits with pregnant women being signed u=
p
for formula clubs, distribution of coupons for infant formula, starter pac=
ks
of artificial baby milk, and literature from infant formula manufacturers.
This commercial pressure continues in the hospital with commercial dischar=
ge
packs, gifts and services to the staff, and large amounts of cash paid to =
the
hospital to accept the free formula supplies used to feed non-breastfed
babies. Some hospitals sell their pre-admission list of pregnant women to
formula companies. These practices make it difficult to fully implement th=
e
Ten Steps to Successful Breastfeeding upon which the Baby Friendly Hospita=
l
Initiative is based. How can you remove some of these barriers to
breastfeeding?
1. Perform a survey of your institution or agency, logging all the items a=
nd
services provided by infant formula companies. Look for the following: are
cans of formula visible to patients, is formula company literature display=
ed
or given to mothers, are there formula club sign-up sheets at the receptio=
n
desk, are mothers given formula gift packs, literature or videos, do formu=
la
companies provide food for staff in-service education programs, does your
hospital have a contract with a formula company specifying a cash payment =
in
return for distribution of formula discharge packs to breastfeeding women,=
are
mothers given cards to remind them to ask for the discharge pack before
leaving the hospital, are staff expenses paid by formula companies to atte=
nd
continuing education programs, sporting events, parties, etc., has your ag=
ency
received architectural services from a formula company? Keep track of thes=
e
practices for several months to produce a log. Ask if any of these product=
s or
services have any therapeutic value to patients. Ask for research-based da=
ta
showing that these products or services benefit mothers and babies. Put a
dollar value on these items and services to illustrate why formula is so
expensive to the mothers who pay for all of these practices. Consider form=
ing
a task force to halt such practices.
2. Check your institution or agency's policy on selling or marketing produ=
cts
to patients. Since discharge packs and gift packs are forms of marketing,
employees may be unknowingly violating institutional policy.
3. Check your job description. Does it mention marketing of products as a
requirement of the job? If not, do not do it. Does your job description or=
any
document you signed as a condition of employment prohibit marketing of
products? If not, you may wish to add this to it for patient protection. I=
f it
does, then avoid giving out discharge packs from commercial interests.
4. Obtain the mission statement of the hospital, agency, or program where =
you
work. Does it mention promotion of health as a goal? If so, ask how market=
ing
formula promotes a health goal. Does it mention marketing commercial produ=
cts
as a means to this goal? If not, avoid using formula company items.
5. Look at the hospital licensure regulations for your state. Do they perm=
it
marketing of products to patients? New York and Massachusetts have specifi=
c
sections in their licensure codes which forbid giving discharge packs
containing formula to breastfeeding mothers unless the mother requests the=
m or
the physician prescribes them. Talk with your state department of public
health as well as the Department of Health Care Quality, informing them of
these practices and asking if these are permissible. Contact your state
attorney general's office and ask if this type of marketing is ethical or
legal in your state.
6. If you are a nurse, contact your state nurse's association regarding th=
e
marketing of products to patients. Does this fall within the scope of prac=
tice
of a nurse? Does it fit in with the ethical practice of the nursing
profession? If not, ask them for a statement to this effect for your use.
7. If you belong to a professional organization, check if it has publicati=
ons
on the ethical practice of your profession. Does it contain any statement =
or
reference on marketing products to patients?
8. Contact both the ethics committee and your hospital's attorney and ask =
for
a statement on the legality and ethical principles behind the issue of the
hospital endorsing products for financial gain, either directly by accepti=
ng
infant formula at no cost, or indirectly by accepting cash grants and
additional services. Remind colleagues that no other product is received b=
y
health care institutions at no cost, in amounts that fulfill the needs of =
the
entire hospital.
9. Ask if your hospital sells pre-registration lists of its maternity pati=
ents
to infant formula companies. If it does, request that the institution refr=
ain
from this practice as it is knowingly increasing health care costs. Ask yo=
ur
state public health department, state hospital association, and state atto=
rney
general if this practice is ethically sound
10. Has your unit been approached to change its breastfeeding policy to al=
low
distribution of formula-containing discharge packs? Formula companies have
offered cash to maternity units for "educational" purposes in return for
changing established unit policy to require giving breastfeeding mothers
commercial discharge packs. This type of bribe can set a dangerous precede=
nt
whereby formula companies may pressure cash-strapped maternity units to ch=
ange
breastfeeding management guidelines to increase the chances that a mother
would need or want to supplement her baby with formula.
11. Has your unit been in-serviced or provided with a document from a form=
ula
company stating that formula supplementing increases breastfeeding duratio=
n?
Be cautious of disinformation and misinformation. Supplementing decreases =
milk
production and can lead to infant illness, as breastmilk with anti-infecti=
ve
properties is replaced with artificial baby milk with no disease protectio=
n.
Before recommending supplementation with formula, check with your medical
director, ethics committee, and hospital attorney regarding ramifications =
of
changing unit policy in order to use interventions which knowingly can lea=
d to
health risks for infants.
12. Obtain a written copy of your institution's vendor policy. Since formu=
la
company representatives frequently do not follow hospital vendor policies =
that
are in use throughout the rest of the hospital, ask that formula companies=
be
held to the same standards. In order to reduce the chances of compromising
patient care, ask that the vendor policy include language that applies to
formula company representatives and prohibits:
o vendor visits without an appointment
o visits to staff not identified as the vendor contact person
o in-services conducted without a documented request from the vendor conta=
ct
person or the maternity unit
o in-services conducted by vendors on topics not directly related to the
vendor's product
o dispensing commercial patient education material
o vendor access to nurses' stations, patient care areas, outpatient clinic=
s,
hallways, lounges, cafeterias, and hospital libraries
o staff from accepting material gifts, gratuities, meals, entertainment, f=
ree
goods, vendor services, or personal expenses. Vendors should be prohibited
from offering these items to any staff, consultants, or attending personne=
l
13. Ask your purchasing department if your hospital has a contract with a
formula company. Request a written copy of this. Ask if any other units ha=
ve a
contract with a supplier to accept free goods in return for marketing thei=
r
products. Ask what the cash is used for and who is accountable for it. All
other units pass on the cost of food to the insurer. Why doesn't the nurse=
ry?
=A9 1998 Marsha Walker, RN, IBCLC
Marsha Walker, RN, IBCLC
Weston, Massachusetts
=========================================================================
Date: Sun, 7 Feb 1999 09:35:29 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Susan Keith-Hergert <[log in to unmask]>
Subject: nipple shields and twins
MIME-Version: 1.0
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Jay, I have a similar case...preemie twins doing well with the small
nipple shields and not yet able to latch to the bare breast. Honestly,
this mom has enough milk to feed quads!!! I am telling her to pump a
couple of times a day to make sure she "empties" herself at least then
(more out of concern for plugged ducts than supply). We are, also
watching her supply closely with pre and post weights on the babies
every other day. I can't imagine telling her to pump after every feed,
as it takes so long to feed these two little people anyway.
It seems to me that, when shields are introduced early, before a good
supply is established, there may indeed be concern about the stimulation
being able to build supply....but...after a mom has proved to be a
producer....maybe not as important.
Will be very interested to hear from others in this matter,
Susan Keith-Hergert RN, MS, CPN, IBCLC
=========================================================================
Date: Sun, 7 Feb 1999 10:03:37 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: newman <[log in to unmask]>
Subject: IVF
Comments: To: Barbara & William Thomas <[log in to unmask]>
MIME-Version: 1.0
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Of course this mother has a choice. She can choose to continue breastfeeding
or not. Here is another example of health professionals assuming the role of
Emperor, not advisors. They can say the IVF is less likely to work if she is
breastfeeding (actually we don't know that--come up with studies to support
your claim, your excellencies). They can make arguments for weaning. But
they cannot say "You must wean".
Jack Newman, MD, FRCPC
=========================================================================
Date: Sun, 7 Feb 1999 10:08:48 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: newman <[log in to unmask]>
Subject: hives
Comments: To: [log in to unmask]
MIME-Version: 1.0
Content-Type: text/plain; charset="iso-8859-1"
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The most common cause of hives is "nobody knows". The second most common
cause of hives is a viral infection. They almost always get better no matter
what within a few days or weeks. Just because the child was better while not
breastfeeding does not mean anything. Hives vary all the time, from day to
day, even minute to minute.
Jack Newman, MD, FRCPC
=========================================================================
Date: Sun, 7 Feb 1999 11:25:56 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: newman <[log in to unmask]>
Subject: website claiming...
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If I recall, someone posted a formula company website recently which talked
about the variability of breastmilk and how their formula was always the
same and implying it was better that way. If this is not a figment of my
fevered imagination, and if you know what I'm talking about, please let me
know the website again.
Jack Newman, MD, FRCPC
=========================================================================
Date: Sun, 7 Feb 1999 09:23:37 -0800
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Janet Simpson <[log in to unmask]>
Subject: Re: Weaning to get pregnant
Mime-Version: 1.0
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Hi All,
This is another of those situations where the mother has four choices: (imho)
1) Do what the Drs wish and wean even tho she does not wnat to and it will
be harmful to the baby
2) Wait until the baby weans then try for another pregnancy
3) Tell the Drs "Thank you for your concern, I have researched this and
have decided to try and become pregnant and continue to BF - the choice is
mine not yours and you cannot FORCE me to do what I do not want to do."
4) (And I know some of you out there will get mad, but oh well) Lie. Tell
the Drs she has weaned even tho she hasn't, try the IUI and continue to
nurse her child.
Sometimes, as we all know, those in the medical profession make STUPID
uninformed statements that they actually know nothing about and put a mother
in a position that, if she wants something bad enough, she may very well
HAVE to lie about her BF relationship to get what she wants (or needs). I
don't think that is an acceptable position for any medical professional to
EVER put a woman in. So when a woman decides that her only choice is to lie
to her HCP, then so be it. If ALL HCPs were educated propeerly in the area
of BF, then BF women would NEVER find it neccessary to lie about whether or
not she is BF during some sort of treatment (that it is OK to BF during, but
the Dr doesn't think so).
Now as a qualifier, I know nothing about IUI, but if it just simply a means
to getting pregnant and there are no drugs involved that would be a risk to
the BF toddler, then what is the big deal? It is HER body and what she
chooses to do with it while trying to get pregnant is HER business.
Up too early this morning...and a bit cranky. Why do we women have to put
up with this sort of garbage?
Jay
Jay Simpson, CLE
Sacramento, California, West Coast, USA
"No Miracles performed here, just a lot of love and hard work."
=========================================================================
Date: Sun, 7 Feb 1999 12:51:08 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Presutti, Lenard" <[log in to unmask]>
Subject: Re: Thyroiditis
Comments: To: stu and jan black <[log in to unmask]>
MIME-Version: 1.0
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Clinical presentation is very important, but there are very specific
tests that can be done to screen for hypo or hyperthyroidism. The most
frequent thyroid condition I have seen postpartum is Hashimoto's
thyroiditis which usually starts with a hyperthyroid phase which
eventually burns the thyroid gland out and the mom becomes hypothyroid.
The best way to screen is to simply do a sensitive TSH and if it
abnormal there are other more specific tests to be ordered.
Len Presutti, DO
Dept. of Fam Med.
Ohio Univ. COM
Athens OH 45701
>----------
>From: stu and jan black[SMTP:[log in to unmask]]
>Sent: Saturday, February 06, 1999 8:48 PM
>Subject: Thyroiditis
>
>Excuse me if I missed some of the background info here.
>Did this Mom have Thyroid levels done?
>When my Son was about 6 months old I crashed into a very painful and life
>changing PPD. I went from Dr to Dr searching for a diagnosis for my
>palpitations, extreme panic attacks etc and one did come up with
>"Thyroiditis" with no testing (can you test for this or only based on
>symptoms?).
>And yes, PPD can be diagnosed as long as 2 yrsafter.
>
>One Psychiatrist insisted I was not depressed, and should begin Betablockers
>for my palps. I suffered for a long time and hope this Mom is getting the
>right diagnosis.
>Respectfully,
>Janet Black RN
>Breastfeeding Counsellor
>Mission BF Support Services
>
>
=========================================================================
Date: Sun, 7 Feb 1999 18:04:32 +0000
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: heather <[log in to unmask]>
Subject: putting up with garbage
Mime-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
Jay asks: Why do we women have to put
up with this sort of garbage?
Well....I can't answer that, but I can add to the pile of garbage observed.
Doesn't it make you mad or sad when you hear a tale of woe and the mother,
far from recognising garbage as garbage, is *grateful* for it?
I have just seen the rough cut of a video I am working with in the day job,
where a mother explains why she is no longer bf.
She 'had a rough time' at the birth and very kindly, the midwives didn't
bring her baby to her for about four hours so she could rest (she hadn't
offered the breast at all at the birth).
Then, the baby wouldn't latch on...for three days. 'The midwives were great
- they had just about every midwife in the hospital trying to get him on,
everyone came with different ideas to try for him and nothing worked - he
just wouldn't open his mouth.'
Well, I can imagine the scenario.
She went on to say she was convinced he was starving, and so she switched
to formula after three days. She feels very sad about this, but feels there
was no alternative.
Who does she blame?
Mostly she blames herself , 'I sometimes feel guilty - maybe I didn't try
hard enough'. She also blames the books she read and her parentcraft
classes for not warning her 'that sometimes, babies just won't latch on.'
She has nothing but praise for the midwives who failed to keep her and her
baby close after the birth, or to help her offer a feed, and who offered a
string of different ideas and different hands....no mention of expressing
her milk, or skin to skin, or continuity of support...nothing.
The saddest thing is that this is a typical picture of bf in the UK -
everyone goes crazy for bf and encourages the mother like mad....but fails
to back it all up with solid knowledge and real change in institutional
practice. These are kind, caring, bf-friendly midwives, who really want to
help and who know bf is important. It's just not enough.
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
=========================================================================
Date: Sun, 7 Feb 1999 18:12:20 +0200
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Moncharsh <[log in to unmask]>
Subject: Re: Hives and Vitamins?
MIME-Version: 1.0
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Dear Cher,
Have no idea if this helps but one of my children broke out in hives from a
vitamin they had taken. As I remember (and the kids are now 23, 21 and 10),
it was a vitamin they had been taking and suddenly developed a sensitivity
to. I don't really remember many of the details. The liklihood is that it
was a healthfood store product.
Donna Moncharsh
=========================================================================
Date: Sun, 7 Feb 1999 14:08:01 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: [log in to unmask]
Subject: Re: shields
Mime-Version: 1.0
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again.. a shield is a ool... as such it is neither good nor bad... its
usage is the de termining factor...
Patricia
=========================================================================
Date: Sun, 7 Feb 1999 14:08:07 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: [log in to unmask]
Subject: Re: formula samples
Mime-Version: 1.0
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Jacie:
companies regularily sell thier mailing lists.. this is a money making
venture.. no more no less.
Patricia
=========================================================================
Date: Sun, 7 Feb 1999 14:08:02 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: [log in to unmask]
Subject: Re: HTLII
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Jack et al:
my office is being painted so nothing is findable.. I can call the speaker
and ask... I have not seen the origional question yet...
Patricia
=========================================================================
Date: Sun, 7 Feb 1999 14:08:04 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: [log in to unmask]
Subject: Re: abscess
Mime-Version: 1.0
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a good supportive reference or this is suan love's breast book... she too
is a rbeast surgeon!
Patricia
=========================================================================
Date: Sun, 7 Feb 1999 14:26:48 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: David and Sandy Riese <[log in to unmask]>
Subject: IVF and Breastfeeding
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Hi Barb
I personally had a similar situation and my specialist told me there
is no need to wean unless we got into medications that indicated a need
to wean. This is just one md's opionion and she is an expert in
infertility. Hope this helps. Sorry no reference.
Sandy Riese, RNC, IBCLC Lancaster (Eastern USA)
=========================================================================
Date: Sun, 7 Feb 1999 15:45:46 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: PrMechell Roberts Turner <[log in to unmask]>
Subject: cabbage ingredients
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charset="iso-8859-1"
I was talking to my local agricultural extension agent a couple of weeks ago
about some animal stuff and if he knwo of local farmers who use cabbage for
engorgement of their breeding females. Yes a gew do but they have troubles
with them eating them. according to him cabbage has large amounts of
estrogen which helps the let down. Infact has more estrogen than a glass of
milk. I have used this on a cat and a bitch dog ( had better clarify there)
and it worked for them and their pups well.
Aslo cabbage is use to trat gastritis as it protects the stomach membrane
from hydrocloric acid and is indicated in use for stomach and duodenal
ulcers.
other ingredients include mustard oils, goitrin, and some sulfonamide type
compounds.
for ulcers take 1 liter of juice daily to a bland diet. ( to get juice it
has to be cooked)
herbal PDR, 1998- this also contains long list for bibliography.
Mechell Turner, M.ED IBCLC, CCE , Student nurse
-----Original Message-----
From: Automatic digest processor <[log in to unmask]>
To: Recipients of LACTNET digests <[log in to unmask]>
Date: Saturday, February 06, 1999 11:08 PM
Subject: LACTNET Digest - 6 Feb 1999 - Special issue
=========================================================================
Date: Sun, 7 Feb 1999 15:52:25 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: PrMechell Roberts Turner <[log in to unmask]>
Subject: pregnancy and supply
MIME-Version: 1.0
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charset="iso-8859-1"
It would be normal to lower supply at the beginning of pregnancy as well as
nipple soreness reported by some- that was my first dead giveaway with no 4.
To increase supply - eat better, drink a lot, blessed thistle , alfalfa or
dandelion would be ok in pregnancy. However, Fenugreek is CONTRAINDICATIED
IN PREGNANCY_ Caps for emphasis not shouting . Fenugreek is know to be a
uterine tonic and stimulant and early in pregnancy can be an abortifacient -
especially when combined with the Cohoshes. If she were in the last few
weeks of pregnancy i would say go ahead with the fenugreek, but she is early
on forget it. if nipples are sore use a little calendula cream.
Mechell Turner, M.Ed., IBCLC, CCE
-----Original Message-----
From: Automatic digest processor <[log in to unmask]>
To: Recipients of LACTNET digests <[log in to unmask]>
Date: Saturday, February 06, 1999 11:08 PM
Subject: LACTNET Digest - 6 Feb 1999 - Special issue
=========================================================================
Date: Sun, 7 Feb 1999 13:04:45 -0800
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Marcia David <[log in to unmask]>
Organization: Heartfelt Center
Subject: NIPPLE SHIELDS
MIME-Version: 1.0
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The newer "contact" nipple shields with a cutout at the top allow more
skin to skin for mom and baby. I have also found that these shields are
less likely to fold back on baby.....my observation and feedback from
moms. I think, as others have said, the most important is that a mom
using a shield is followed. I am still surprised to find moms who have
not been told that they can try putting the baby directly to breast at
any feeding to see how things go. For some, it seems they are waiting
for permission from "someone in the know" to do this. I readily offer
this option to moms who come to me (or by phone) and I am delighted when
nursing w/out a shield occurs for the first time. Such pleasure on a
mom's face!
=========================================================================
Date: Sun, 7 Feb 1999 13:28:56 -0800
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Marcia David <[log in to unmask]>
Organization: Heartfelt Center
Subject: Touching
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I never touch a mom's breasts w/out asking permission. That is common
courtesy and how I want to be treated. Mom's often are surprised when I
ask as they have just come from the hospital setting where there is so
much touching w/out permission. It only takes a second to ask and it
means so much, particularly to new moms who can be at their most
vulnerable.
=========================================================================
Date: Sun, 7 Feb 1999 16:33:28 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Cathy Bargar <[log in to unmask]>
Subject: nipple shields
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Finding Jay's, Heather's, Joy's, et al posts re nipple shields interesting
& thought-provoking. Heather, I agree with all you said about nipple
shields, and I am aware that most of the current research supports a healthy
dose of caution and watchfulness in their use. But I think back to my own
experiences: Baby #1, horrible painful cracked bleeding "hamburger"
nipples - not one word of advice re: positioning, latch-on,etc. - hosp.
handed me a funky old-fashioned nipple shield (the kind made out of glass,
shaped like the neck of a bottle with a regular long bottle nipple attached
to the end. Baby's mouth is a good 31/2" away from the breast with this
device, and not even as much stim. as with the old rubber sombrero types -
there must be others of you out there who remember this type.) Anyway, the
thing allowed me to keep nursing; I otherwise would have stopped by day 5
because of the pain. The kid grew & gained well at first, then gradually
slipped into the kind of downward spiral described by Heather - increasingly
fussy, loss of confidence on my part, no reinforcement or supporting advice,
persisted for 6 months (not exclusively) or so. Not a very positive
experience, but more so than if I had given up on my poor bloody nippes in
the first week.
Babies #2 & 3 (twins): same miserable bleeding eroded nipples, same
unbelievable nipple pain, same antique shield, same lack of BF skills, but
the babies grew and thrived and my supply never dwindled (au contraire!). I
think it took about 6 weeks, in each case, for my nips to heal enough to
ditch the shield. The twins went along to nurse without any significant
problems till 14 months.
What's my point? Seems to me (just my experience, not sure about clinical
research on this) that the difference between those two experiences was due
to the *constant* stimulation supplied by nsg. twins, and my willingness to
nurse either one of them whenever they so much as peeped (vs. trying to
"hold off" 1st baby to 3 hr. fdgs as nurses had instructed). So frequent
vigorous nsg. was overcoming the neg. effect of this ridiculous shield. But
no matter how horrid that thing was (you young'uns would die to see this
thing!), I would *never* have persisted with breastfeeding without it. I
think, and there is research to support it, that there is a place for nipple
shields, properly used within a good LC/mom collaboration. And, as with most
things, successful and appropriate use will vary. And as Pat reminds us,
just a tool.
Cathy Bargar RN, IBCLC
=========================================================================
Date: Sun, 7 Feb 1999 16:59:40 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Cathy Bargar <[log in to unmask]>
Subject: Re: shields & twins
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Susan Keith-Herget and Jay have both written about twins and nipple shields,
and I just fired off my own 2 cents worth on the subject. So this is really
making me wonder whether with multiples there really is something
significant going on, or if it's just that with so much more stimulation
from the extra load of nsg/pumping it's easier for there to be increased
production. Do we know what goes on with the conributing hormones with
multiples? Do we get prolactin/oxytocin levels that are twice as high, or
just more frequent spikes because of more frequent/longer nsg.? And what
about the supposed inhibitory effects of fluid volume overload in some
cases? (like my situation - twin preg + polyhydramnios + CS delivery with
lots of IV fluids, + didn't put those babies anywhere near my breast for >36
hrs, yet enough milk to feed a small country).
Susan also says "I can't imagine telling her to pump after every feed,
as it takes so long to feed these two little people anyway." Well, you're
right on target with that one! As committed as I was to BFing, I don't think
I would have been able to persist if I'd been told to pump after every feed!
(And I say that not being at all critical of one who would give that
advice - I think I've probably recommended it myself, and I understand those
situations where it might be the way to go. Just my "body memory" of those
early days nsg. twins!)
So many interesting things to ponder!
Cathy Bargar, RN, IBCLC
It seems to me that, when shields are introduced early, before a good
supply is established, there may indeed be concern about the stimulation
being able to build supply....but...after a mom has proved to be a
producer....maybe not as important.
=========================================================================
Date: Sun, 7 Feb 1999 16:01:58 -0600
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: libe <[log in to unmask]>
Subject: BATTERY
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This theme has been interesting, but does seem full of assumptions and not
much legal accuracy. I am fortunate to live with a Judge so he pulled out
the statutes,(granted we live in Kansas-but he said this definition is
predominant nationally.
KSA 21-3412 Battery. Battery is :
(a) Intentionally or recklessly causing bodily harm to another person;
or
(b) intentionally causing physical contact with another person when
done in a rude, insulting or angry manner.
Battery is a class B person misdemeanor.
I find it hard to believe that if a person is seeking your assistance with
breastfeeding and you touch her or her baby, that that action could ever be
defined or found as battery. I think the policeman in the one example given
was not speaking from a knowledge base, or else he assumed that the contact
was done in a rude, insulting or angry manner. By the way my husband find
the courtroom scenes on TV as distressing as we all find the medical shows.
There is a lot of misinformation out there!
Thanks for listening,
Libby Rosen, RN, IBCLC
Topeka, Kansas
=========================================================================
Date: Sun, 7 Feb 1999 17:08:11 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Reinaldo Vilabona <[log in to unmask]>
Subject: Re: smells,touch(long)
MIME-Version: 1.0
Content-Transfer-Encoding: quoted-printable
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charset="iso-8859-1"
More about Smells/touch:
My wife used to be able to tell when one of our daughters was sick, just =
by smelling them, and still is while working as a pre-school teacher.
Two fascinating books on the subjects; "The Perfume", by Patrick Suskind
"'Touching"", by Axel Mantagu.
Should be read at all Nursing/Medical/Social Workers/ schools, and of =
course, practiced!
Last, but not least, the "scientific"' evidence:
"'The neuropsychologist James W. Prescott has performed a startling =
cross-cultural statistical analysis of 400 preindustrial societies and =
found that cultures that lavish physical affection on infants tend to be =
disinclined to violence. Even societies without notable fondling of =
infants develop nonviolent adults, provided sexual activity in =
adolescents is not repressed. Prescott believes that cultures with a =
predisposition for violence are composed of individuals who have been =
deprived=97during at least one of two critical stages in life, infancy =
and adolescence=97of the pleasures of the body. Where physical affection =
is encouraged, theft, organized religion and invidious displays of =
wealth are inconspicuous; where infants are physically punished, there =
tends to be slavery, frequent killing, torturing and mutilation of =
enemies, a devotion to the inferiority of women, and a belief in one or =
more supernatural beings who intervene in daily life.=20
Prescott writes:
=93The percent likelihood of a society becoming physically violent if it =
is physically affectionate toward its infants and tolerant of premarital =
sexual behavior is 2 percent. The probability of this
relationship occurring by chance is 125,000 to one. I am not aware of =
any other developmental variable that has such a high degree of =
predictive validity."=20
Infants hunger for physical affection; adolescents are strongly driven =
to sexual activity. If youngsters had their way, societies might develop =
in which adults have little tolerance for aggression, territoriality, =
ritual and social hierarchy (although in the course of growing up the =
children might well experience these reptilian behaviors). If Prescott =
is right, in an age of nuclear weapons and effective contraceptives, =
child abuse and severe sexual repression are crimes against humanity. =
More work on this provocative thesis is clearly needed. Meanwhile, we =
can each make a personal and noncontroversial contribution to the future =
of the world by hugging our infants tenderly.
(Cited by Carl Sagan in =93Cosmos=94,Ch. 13, pg. 274; Ballantine Books, =
1985)
=========================================================================
Date: Sun, 7 Feb 1999 16:10:03 -0600
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Jeanne Mitchell <[log in to unmask]>
Subject: Re: Hives and Vitamins?
MIME-Version: 1.0
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I have to be careful with natural vitamins. I am allergic to nuts and
fresh nutmeg. Some B-complex vitamins give me an allergic reaction.
Wish I knew what they all have in common. The nutmeg reaction was a big
surprise to me about a year ago.
I would look again at the 2-year old's direct diet. Is there something
she ate that she hasn't had in awhile?
--
Jeanne Mitchell, Austin, TX
http://www.flash.net/~xanth/home.htm
mailto:[log in to unmask]
"You can tell the quality of a person by how
they treat people they don't need." My Dad
=========================================================================
Date: Sun, 7 Feb 1999 17:14:19 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Reinaldo Vilabona <[log in to unmask]>
Subject: Fw: smells,touch(long)2Apologies
MIME-Version: 1.0
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Sorry to all, but missed my signature/name: (busy week, I guess!)
R. Villabona, MD
in NY/NJ, with light snow
-----Original Message-----
From: Reinaldo Vilabona <[log in to unmask]>
To: Lactation Information and Discussion <[log in to unmask]>
Date: Sunday, February 07, 1999 5:08 PM
Subject: Re: smells,touch(long)
More about Smells/touch:
My wife used to be able to tell when one of our daughters was sick, just =
by smelling them, and still is while working as a pre-school teacher.
Two fascinating books on the subjects; "The Perfume", by Patrick Suskind
"'Touching"", by Axel Mantagu.
Should be read at all Nursing/Medical/Social Workers/ schools, and of =
course, practiced!
Last, but not least, the "scientific"' evidence:
"'The neuropsychologist James W. Prescott has performed a startling =
cross-cultural statistical analysis of 400 preindustrial societies and =
found that cultures that lavish physical affection on infants tend to be =
disinclined to violence. Even societies without notable fondling of =
infants develop nonviolent adults, provided sexual activity in =
adolescents is not repressed. Prescott believes that cultures with a =
predisposition for violence are composed of individuals who have been =
deprived=97during at least one of two critical stages in life, infancy =
and adolescence=97of the pleasures of the body. Where physical affection =
is encouraged, theft, organized religion and invidious displays of =
wealth are inconspicuous; where infants are physically punished, there =
tends to be slavery, frequent killing, torturing and mutilation of =
enemies, a devotion to the inferiority of women, and a belief in one or =
more supernatural beings who intervene in daily life.=20
Prescott writes:
=93The percent likelihood of a society becoming physically violent if it =
is physically affectionate toward its infants and tolerant of premarital =
sexual behavior is 2 percent. The probability of this
relationship occurring by chance is 125,000 to one. I am not aware of =
any other developmental variable that has such a high degree of =
predictive validity."=20
Infants hunger for physical affection; adolescents are strongly driven =
to sexual activity. If youngsters had their way, societies might develop =
in which adults have little tolerance for aggression, territoriality, =
ritual and social hierarchy (although in the course of growing up the =
children might well experience these reptilian behaviors). If Prescott =
is right, in an age of nuclear weapons and effective contraceptives, =
child abuse and severe sexual repression are crimes against humanity. =
More work on this provocative thesis is clearly needed. Meanwhile, we =
can each make a personal and noncontroversial contribution to the future =
of the world by hugging our infants tenderly.
(Cited by Carl Sagan in =93Cosmos=94,Ch. 13, pg. 274; Ballantine Books, =
1985)
=========================================================================
Date: Sun, 7 Feb 1999 22:23:25 +0000
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: heather <[log in to unmask]>
Subject: horrible shield
Mime-Version: 1.0
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Cathy reminds us of those awful plastic and rubber thingies issued as a bf
'aid' to mothers - yes I remember them, and they were 'old fashioned' 19
years ago when the mother in the next bed to me got one. I got one, too,
but my daughter gagged on it, as far as I remember, and I was given a
Mexican hat instead - it didn't help my soreness one little bit and I
abandoned it (I remember taking it off and seeing it full of blood....!)
But would you believe it, just three days ago I was talking to another bfc
and she said a mother she was helping had been given one of the horrible
ones just a couple of weeks ago...so they are still out there, in Scotland
anyway, where the bfc was working.
Some day, I'm going to start a museum of breastfeeding, and have a glass
case full of dreadful stuff, like the lead piping contraptions illustrated
in Milk Money and Madness and similar books (think it's in there - Valerie
Fildes' work has some hair-raising pix, too).
We keep saying shields are 'just a tool' - true. Maybe you should have
special licence to use one, awarded after specific training. And there
should be a health warning on the boxes.
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
=========================================================================
Date: Sun, 7 Feb 1999 17:30:05 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: [log in to unmask]
Subject: Re: nipple shields revisited
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Susan:
I would encourage everyone to go back and look at the origional research...
There is NO data to substantiate the loss of a milk supply from using a nipple
shield APPRPRIATELY...
Without question, if the baby is not latched on correctly, if the baby is
not feeding frequently enough the mothers milk supply will most likely drop...
but not because of the use of a nipple shield.
There are 7 studies that have been done on the use of the nipple shield...
Michael Woolridge's study in 1980 using three different shields, the
mexican hat... and a thin latex ( 1.5mm thick) nipple shield heights 1.4 adn
1.8 cm. although he found a 22% reduction in intake he considered this not to
be significant. - (18 mother baby pairs)
Alan Lucas using the same two latex shileds with 10 mothers found NO
signficant difference. (10 mothers)
Williams in 1985 using a .5mm latex shield found a significant difference
in intake but his study was about milk sampling. ( 30 mothers)
Jackson used the same sheild as Williams but found only a 17% reduction in
intake (13 mothers)
Amatayakul used the same latex shield as M. Wooldridge and found a
signicficant reduction in intake. (16 mothers)
Auerbach using a shield that was 2.2 cm in height with either 4 or 1
hole scoring mothers who were pumping found a significant reduction in
intake... ( 25 mothers)
There are many pieces that need to be looked at with these studies - there
is no uniformity of equipement used, in some cases the shields used were for
milk sampling and were constructed very differently than those that we use in
clinical practice. there are variations in thickness, material and heights.
All the mothers in these studies were bf without problems.. this is very
different from the situation where a mother is experiecing dificulties and we
introduce a shield as an aid...
I think that it is arduous to be doing test weights on feeds unless there
are reasons other than the use of the shield, I also think that a mother
expereicing difficulties has enough on her plate without adding pumping
(unless like susan's mom there is a concern that her production is so high she
is at risk for other difficulties. )
There is a fair amount of data available, expecially from australia, on
the appropriate use of the nipple shield as a tool that we should read and be
open to.
( additionally the JHL issue)
granted this does not negate the problems of their overuse by
practicioners who do not take the time to 'fix the problem"... but this
happens with many tools... In another state that live oned of the local
hospitals appeared to send ALL babies home finger feeding.. this was their
answer to all bf problems.. was this right... but did it make ALL
fingerfeeding WRONG..
sorry to run on so... I stand with Joy on feeling very strongly that the
nipple shield is a tool - if used appropriately it is excellent, if use
inappropriately it can create more difficulties.. but its "goodness" or
"badness" should be assigned to its usage not its being.
Patricia
=========================================================================
Date: Sun, 7 Feb 1999 18:05:13 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Cathy Bargar <[log in to unmask]>
Subject: ancient torture device
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Thank you, Heather, for knowing the so-called shield I was talking about.
Most of the people I have occasion to talk about it with in the US have
never seen such a thing - makes me feel very old! The fact that I ever
produced a drop of milk at all using that thing is a testimony to the
miraculous and determined strength of the way we're built!
you say <<We keep saying shields are 'just a tool' - true. Maybe you should
have special licence to use one, awarded after specific training. And there
should be a health warning on the boxes.>>
When I first worked in the hosp., there were no shields stocked, but the
nurses were quite fond of taking a regular long artificial teat, cutting off
the end of it, and giving that as a so-called shield. They were very
churlish about giving up that practice, and I think they never did believe
that there was anything wrong with it(and probably back at it, now that I'm
gone and can't get them in trouble for it anymore!) Later, at WIC, after the
JHL issue about shield use came out, I did purchase a few to use through
WIC, but wrote policy that no one but an IBCLC (that was me, within the
agency)could give them out or recommend the use of them, and I included
appropriate use, management, and follow-up in the policy even though it was
only I that even knew where the things were kept. You would have thought I
was talking about dispensing plutonium or something. rather than a little
piece of silicone anyone could buy at the local pharmacy!
Cathy Bargar, RN, IBCLC
=========================================================================
Date: Sun, 7 Feb 1999 18:29:51 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Jan Barger RN, IBCLC" <[log in to unmask]>
Subject: Scientific "proof" for cabbage
Mime-Version: 1.0
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Leila says,
<< I thought that the effectivness of the cabbage leaves hadn't been
scientifically proven, (La Leche League's, The Breastfeeding Handbook).
>>
Yes, you are quite right. However, if you look at ALL the studies that have
been done on cabbage, none of them have replicated the procedure described in
the case report study by Wendy Rosier in BF Review, November, 1987. As soon
as someone replicates her study in other than a case study approach, maybe we
will find out that cabbage is effective, other than in anecdotal reports.
As you may recall, if you have read the salient articles, you will know that
Rosier put the cabbage leaves on for 2 hours, off for 2 hours, on for 2 hours,
and so on. Nicoderm, in the Birth article in 1990 (?) used cabbage for 20
minutes 4 times a day, and concluded there was no difference between those who
used cabbage and those who didn't. So, I would hardly use that "study" as
refuting the Rosier "study."
If someone would like to do a study on cabbage, I would suggest that since
there are no time frames established for it's use in "The Glory of Woman"
(1882), you at least use Rosier's parameters in the research project.
BTW, didn't Andrew mention something about cabbage being used for arthritic
joints? Was that article based on research or case studies?
Jan Barger, RN, MA, IBCLC
Queen of Cabbage
=========================================================================
Date: Sun, 7 Feb 1999 17:36:59 -0600
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Julius Edlavitch MD <[log in to unmask]>
Subject: BREASTFEEDING INTERNET CHAT
Mime-Version: 1.0
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BREASTFEEDING DISCUSSIONS
Monday February 8th, 1999
DAVID C. PAGE, DDS
Will discuss the development of a newborn's palate in
breast fed vs bottle fed infants.
Monday February 15th, 1999
Not sure yet, but trying for Donald Cook MD
Julius Edlavitch MD
International Pediatric Chat
=========================================================================
Date: Sun, 7 Feb 1999 19:06:15 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
Comments: SoVerNet Verification (on pike.sover.net) oemcomputer from
arc4a70.bf.sover.net [209.198.82.200] 209.198.82.200 Sun, 7 Feb
1999 19:11:33 -0500 (EST)
From: kersula family <[log in to unmask]>
Subject: Touch
In-Reply-To: <[log in to unmask]>
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The author of _Touching_ is Ashley Montague, I believe.
Dawn Kersula in Southern Vermont
=========================================================================
Date: Sun, 7 Feb 1999 18:06:17 -0600
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Kathy Dettwyler <[log in to unmask]>
Subject: Touching
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Content-Type: text/plain; charset="us-ascii"
>"Touching" by Axel Mantagu
That's Ashley Montagu. ;)
=========================================================================
Date: Sun, 7 Feb 1999 16:42:38 -0800
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Chris Hafner-Eaton <[log in to unmask]>
Subject: Re: Cabbage Leaves - active ingredients, treatments, and washing?
Comments: To: Lelia O'Callaghan <[log in to unmask]>
MIME-Version: 1.0
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Leila: According to the APHA Control of Communicable Diseases Manual (p251)
Listeriosis "occurs sporadically ; however, several outbreaks have been
recognized in recent years, occurring in all seasons. About 30% of clinical
cases occur within the first 3 weeks of life." Other than birth, person to
person contact may occur venerally. Regarding the reservoir..."the
principal reservoir of the organism is in forage, water, mud and silage.
The seasonal use of silage as fodder is frequently followed by an increased
incidence of listeriosis in animals." Cheese and other products from
unpasteurized milk are the main cause of outbreaks in humans. Thus, it is
possible that the cole slaw outbreak was caused either by the cabbage OR by
the milk products used. Incubation is 3-70 days; the period of
communicability after birth is is 7-10days.
The problem is that we don't know exactly which ingredients do the "active"
work; thus, cosmetic companies (and even one company targeting bf moms, as
well as those who want to "dry up") are now grinding up entire cabbage
leaves to include in their ingredients. There is some synergistic effect,
which has blocked the ability to isolate one ingredient. IMHO, LLLI tends
to be exceedingly conservative regarding certain things. This is one of
them. Now that I'm retired as an LLLL and don't speak officially for them I
can say that. I do know that cabbage leaves have been scientifically
demonstrated to reduce swelling in athletic injuries. As for washing,
there are two recommended methods (no agreement): soapy hot water or
diluted bleach and water. Microwaving them should kill listeriosis I hope
that helps a bit.
Chris
->
=========================================================================
Date: Sun, 7 Feb 1999 20:08:32 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: trainar <[log in to unmask]>
Subject: Re: Formula packs
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Here is a thought about discharge formula bags. Mothers have been told by
friends and family that they should get the "pretty" bags, even if they do
not use the contents, it's free! (and cheaper than buying a diaper bag I
guess.) I've even had mother's bring in coupons they received in the mail
requesting bags from both formula companies even if they are breastfeeding,
again it's the "free" thing. The hospital probably has entered into
agreement with the formula companies to distribute these "freebies" to the
new moms in exchange for formula for the infants at little or no cost to
the hospitals. The hospitals would also get a break on the purchase of
the "adult" formulas that are used for many debilitated patients. I've not
seem this in writing but from conversations with the formula reps this
situation is certainly implied. It's pure economics and no nurse who
wants to keep her job would empty those bags before giving them out. That
apparently is also in the agreement.
Anyone out there who is on the administrative side of feeding infants in
hospitals who could confirm or deny this?
Rita Traina RNC, IBCLC
WET MID-JERSEY
=========================================================================
Date: Sun, 7 Feb 1999 23:44:50 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Cathy Bargar <[log in to unmask]>
Subject: Re: Breast Abscess
Comments: To: "Jane Ciaramella RNC, IBCLC" <[log in to unmask]>
MIME-Version: 1.0
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Jane writes, re: her mom with a breast abscess & surgeon who said she
"couldn't" BF after I&D: "Any comments, ideas on what I could have done
differently? I have not spoken to the surgeon, but would like to? Any
research on this? Any help would be appreciated."
Jane, I understand your frustration on this - another example of "whose baby
is it anyway?" Not to mention "whose body?"! But as to what more you
coulda-woulda-shoulda done, it sounds to me you did exactly what was within
your power to do. I keep thinking about this poor woman going through all
that pain and stress, and I'm picturing this woman who's just all worn out
from everything she's had to go through with this, and it's so unfortunately
easy to see how she just did what the surgeon said to do. You know, we all
think he gave bad advice (or orders, more like it!) based on a poor
knowledge of physiology and lactation (as Jack so succinctly noted), but
ultimately the decision WAS hers, whether she is able at this stage to own
it or not. So you did what you could do, and I'll bet you did it well, and
I'll bet you didn't leave her feeling stupid or bullied either. I've never
had a breast abscess, but I can easily imagine it hurting enough that I'd be
afraid to nurse.
Does she know that it's not too late to nurse at least on the other side if
she would like to? Or is it a closed issue for her? It's so sad that women
have to fight "authorities" at a time when they are in pain and need!
Cathy Bargar, RN, IBCLC
-----Original Message-----
From: Jane Ciaramella RNC, IBCLC [mailto:[log in to unmask]]
Sent: Saturday, February 06, 1999 11:05 PM
Subject: Re: Breast Abscess
I saw a Mom on Friday who was diagnosed with a breast abscess 2 days prior
to
when I saw her. She came to me to discuss the possibility of continuing to
breastfeed even with abscess. I have limited experience with this condition
so
most of my knowledge is book knowledge in this respect. I shared with her
the
section in The LLL Answer Book, Auerback, and The Breastfeeding Counseling
Guide in order to give her more information with which to make an informed
decision. She expressed a strong desire to continue to BF her 3 month old
baby
who was even having allergic reactions on breastmilk only. He had had
episodes
of blood in stools and Mom had done lots of diet modifications under the
guidance of her Ped.
The surgeon, who has a very good rep in this area, advised weaning in no
uncertain terms. Mom contacted LLL , and was told she could BF even after
I&D.
I basically gave her that same information and we discussed all of her
options
of how to continue.
She saw surgeon right after me and the surgeon flat out told her NO! She was
not given a choice! If I was this Mom I would have felt strong enough to say
this is my baby and my decision , thank you for the good job on the I&D and
that's as far as your involvement goes! I tried to encourage this Mom to
make
her own informed decision given the information in the literature but I felt
like she was bullied into thinking her own health would suffer irreparably
if
she did not wean.
I even talked about BF from one breast as a last resort. She was too teary
to
talk at that point.
Any comments, ideas on what I could have done differently? I have not spoken
to the surgeon, but would like to? Any research on this?
Any help would be appreciated.
Jane Ciaramella RNC, IBCLC