The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS,
a homebirth midwife in Mountain View, CA
The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS,
a homebirth midwife in Mountain View, CA
|
Orgasmic Birth -- the documentary! ABC's 20/20 will be airing a segment about Orgasmic Birth on May
16th for their special Mother's Day show.
Interviews with Christiane Northrup, MD, Ina May Gaskin, MA, CPM, Sarah J Buckley, MD, Marsden Wagner, MD Joyous, sensuous and revolutionary, this pioneering film will compel many to reexamine their perceptions about childbirth. Viewers will understand how the use of normal, undisturbed birthing methods can aid the health and well-being of future generations. |
The
impact of traumatic birth experiences on breastfeeding.
|
"The health care dollars saved by breastfeeding would amount to $3.6 billion" - Dr. Stephen Buescher |
Initiation of Breastfeeding
by Breast Crawl - this is similar to the Breast Self Attachment video.
YOUR
BABY KNOWS HOW TO LATCH-ON - Great 5-minute video from ameda.com
Welcome to Mom's Breastaurant!
- At Mom’s Breastaurant our mission is to promote a breastfeeding culture
by giving breastfeeding moms a safe, comfortable, clean place to nurse
during outdoor events such as street fairs, festivals, and concerts. Our
tents are temperature controlled, have comfortable chairs and offer clean
diaper changing stations.
The Academy of Breastfeeding Medicine
Delayed
Breastfeeding Initiation Increases Risk of Neonatal Mortality
PEDIATRICS Vol. 117 No. 3 March 2006, pp. e380-e386 (doi:10.1542/peds.2005-1496)
CONCLUSIONS. Promotion of early initiation of breastfeeding has the potential to make a major contribution to the achievement of the child survival millennium development goal; 16% of neonatal deaths could be saved if all infants were breastfed from day 1 and 22% if breastfeeding started within the first hour.
This is a pretty amazing statistic, and it's important to consider this anytime you're also considering the safety of birthing practices that affect breastfeeding:
Drugs
Cesarean
Separation of mother and baby
Circumcision
There's a great book about this, Impact of Birthing Practices on Breastfeeding: Protecting the Mother and Baby Continuum by Mary Kroeger
The breastfeeding rates in my homebirth practice are close to 100%,
and if you consider how significantly this increases birthing safety, it
makes homebirth significantly safer than hospital birth.
I love this
t-shirt for mamas that reads, "I Make Milk - What's Your Super Power?"
Right on!!!
And, of course, how could we go through life without a Dr. Seuss-style verse about breastfeeding:
Would you nurse her at the park?
Would you nurse him in the dark?
Would you nurse him with a boppy?
And when your boobs are feeling floppy?,
etc.
Mandy
& Matt: A solution for breastfeeding attachment through co-bathing
by Midwifery Birthing Services - Shows how the techniques can be adapted
and used when mother and baby are having problems establishing breastfeeding.
If the first hours after birth have been disturbed and mother and baby
have not been able to learn together how to breastfeed, resulting problems
can be corrected by creating the conditions that trigger the innate reflexes
in the baby, thus enabling the baby to relearn how to find the nipple,
attach and suck successfully.
Babies have mirror neurons (also called mimc neurons) that cause them to mimic others' actions. So if you want your baby to open the mouth in a nice, wide gape to latch on, show your baby what you mean, and really stretch that mouth wide open!!! (Yes, this is the basis for the old "monkey see, monkey do" truism!)
Neural
mechanisms of imitation.
Iacoboni M.
Curr Opin Neurobiol. 2005 Dec;15(6):632-7. Epub 2005 Nov 3.
Does
continuity of care by well-trained breastfeeding counselors improve a mother's
perception of support?
Ekstrom A, Widstrom AM, Nissen E.
Birth. 2006 Jun;33(2):123-30.
" . . . the mothers were more satisfied with emotional and informative
support during the first 9 months postpartum. The results lend support
to family classes incorporating continuity of care."
A
Mother's Feelings for Her Infant Are Strengthened by Excellent Breastfeeding
Counseling and Continuity of Care
Anette Ekström, PhD, RNM and Eva Nissen, PhD, RNMTD
PEDIATRICS Vol. 118 No. 2 August 2006, pp. e309-e314 (doi:10.1542/peds.2005-2064)
CONCLUSION. . . . guaranteed continuity of care strengthened the maternal
relationship with the infant and the feelings for the infant.
LLLI Responds
to AAP Policy Statement on Sudden Infant Death Syndrome
Massachusetts
Breastfeeding Coalition's Response to AAP SIDS Recommendations
Breastfeeding
Is Associated with a Lower Risk of SIDS According to The
Academy of Breastfeeding Medicine
How to Find Lactation Consultants
15 Years After
Innocenti Declaration, Breastfeeding Saving Six Million Lives Annually
- Unicef Press release [22 November 2005] – Six million lives a year are
being saved by exclusive breastfeeding, and global breastfeeding rates
have risen by at least 15 per cent since 1990.
Clinical Protocols
from The Academy of Breast Feeding Medicine
Breastfeeding
Rates in US Baby-Friendly Hospitals: Results of a National Survey
Anne Merewood, MA, IBCLC*,{ddagger}, Supriya D. Mehta, PhD, MHS§,
Laura Beth Chamberlain, BA, IBCLC{ddagger}, Barbara L. Philipp, MD*,{ddagger}
and Howard Bauchner, MD, MPH*,||
PEDIATRICS Vol. 116 No. 3 September 2005, pp. 628-634 (doi:10.1542/peds.2004-1636)
Conclusion. Baby-Friendly designated hospitals in the United States have elevated rates of breastfeeding initiation and exclusivity. Elevated rates persist regardless of demographic factors that are traditionally linked with low breastfeeding rates.
Here's the list of Baby-Friendly
Hospitals and Birth Centers.
Nurse-N-Glow Pillow - an all-in-one night-time nursing aid. Seems like a great shower gift to me, and no, I'm not making any money off this recommendation . . . I'm just *so* impressed that someone would design something that is so obviously designed to make nightime nursing and co-sleeping easier. Thank you!!!
Wow! I can't believe I'm raving about this product because it's
not the bells and whistles that produce the breastmilk, but it seems really
well designed and really, really useful!
Breast is
Best, but it Could Be Better: What is in Breast Milk That Should Not Be?
[Medscape registration is free] This article provides many helpful
tips about avoiding toxic chemicals that could be passed to your baby through
breastmilk. [NOTE - Compounds
found in air in the home could pose more of a health risk to breast-fed
babies than chemicals they are exposed to through their mother's milk,
researchers in the United States said on Tuesday. They found that
a nursing infant's exposure to gases known as volatile organic compounds
(VOCs) from indoor air was 25-135-fold higher than from breast milk.]
Levels of
Lead in Breast Milk "Quite Low" Even With High Maternal Lead Exposure
AAP Releases Revised Breastfeeding Recommendations (Feb., 2005)
The policy recommendations include:
* Exclusive breastfeeding for approximately the first
six months and support for breastfeeding for the first year and beyond
as long as mutually desired by mother and child.
* Mother and infant should sleep in proximity to
each other to facilitate breastfeeding;
* Self-examination of mother's breasts for lumps
is recommended throughout lactation, not just after weaning;
* Support efforts of parents and the courts to ensure
continuation of breastfeeding in cases of separation, custody and visitation;
* Pediatricians should counsel adoptive mothers
on the benefits of induced lactation through hormonal therapy or mechanical
stimulation.
* Recognize and work with cultural diversity in
breastfeeding practices
* A pediatrician or other knowledgeable and experienced
health care professional should evaluate a newborn breastfed infant at
3 to 5 days of age and again at 2 to 3 weeks of age to be sure the infant
is feeding and growing well.
Of particular interest to midwifery and natural childbirth advocates
are changes from the 1997 policy. In particular, the policy includes
as additional ways to support breastfeeding avoiding procedures that interfere
with breastfeeding or traumatize the infant, including unnecessary, excessive
and overvigorous suctioning of the oral cavity etc. Under immediate postpartum
care, health care professionals are urged to allow skin to skin contact
immediately upon delivery and continuing until the first feeding is completed.
The policy states that a few assessment measures can be accomplished while
the newborn is with the mother and lists others that should be delayed
(weighing, measuring, bathing, etc.) until after the first feeding, and
that the mother is an "optimal heat source for the infant." These
policy statements are right in line with what midwives already try to do!
In addition to its many known bonding and health benefits, breastfeeding appears to lower the risk of a baby dying during its first year of life, US research indicates. "Breastfed infants in the United States have lower rates of morbidity, especially from infectious disease, but there are few contemporary studies in the developed world of the effect of breastfeeding on postneonatal mortality," the researchers observe. To address this issue, Aimin Chen and Walter Rogan, from the National Institute of Environmental Health Sciences in North Carolina, analyzed data from the 1998 National Maternal and Infant Health Survey. They compared breastfeeding patterns between 1204 infants who suffered postneonatal death-between 28 days and 1 year of age, for reasons other than cancer and congenital anomaly-and 7740 who were still alive aged 1 year. Children who had ever been breastfed were 21 percent less likely to die during the postneonatal period than those who had never been breastfed, and the risk declined with increasing duration of breastfeeding. In addition, the level of protection provided by breastfeeding varied with cause of death, ranging from an odds ratio of 0.59 for injuries to 0.84 for sudden infant death syndrome. Chen and Rogan conclude that "assuming causality... promoting breastfeeding has the potential to save or delay approximately 720 postneonatal deaths in the USA each year."
We have known for a long time that breastfeeding offers very significant
health advantages to babies and children. It is time that the evaluation
of all aspects of perinatal care integrate this factor in assessing safety.
For example, homebirth is exemplary in promoting breastfeeding . . . there
is no separation of mother and baby as observation of unstable newborns
takes place right in mother's arms, suctioning that might affect breastfeeding
is kept to the minimum necessary for safety, and babies aren't subjected
to the hospital germs which could make them sick and unable to nurse. The
negative effects of circumcision on breastfeeding must also be considered
a specific danger of circumcision.
Fentanyl during labor may impede breastfeeding
The impact of intrapartum analgesia on infant feeding
Sue Jordana, Simon Emeryb, Ceri Bradshawa, Alan Watkinsc Wendy Friswellb
BJOG: An International Journal of Obstetrics & Gynaecology 112
(7), 927-934.
Conclusions A dose response relationship between fentanyl and
artificial feeding has not been reported elsewhere. When well-established
determinants of infant feeding are accounted for, intrapartum fentanyl
may impede establishment of breastfeeding, particularly at higher doses.
Breast milk protects against diarrhea [10/25/04] - The Journal of Pediatrics 2004; 145: 297-303
Research findings suggest another positive reason for mothers to breast-feed their babies.
Oligosaccharides in breast milk can help to protect infants against
diarrhea, researchers have found, providing more evidence in support of
breast-feeding.
Milk storage diminishes antioxidant activity [10/25/04] - Archives of Disease in Childhood Fetal and Neonatal Edition 2004; 89: F518-20
Assessing the effect of storage conditions on the antioxidant content of human and formula milk.
Breast milk loses its antioxidant activity if stored for longer than 48 hours, study findings indicate, although refrigeration is better than freezing and thawing in this regard.
N. Hanna (Robert Wood Johnson Medical School, New Jersey) and co-workers measured the antioxidant activity of a range of human term and preterm milk, as well as five brands of formula milk, stored for different periods at various temperatures.
Fresh human milk had the highest antioxidant capacity of all the samples, irrespective of whether the mother had delivered prematurely or at term.
Furthermore, fresh human milk had significantly higher antioxidant activity than all formula milks tested.
With respect to storage of human milk, however, antioxidant activity
was reduced if milk was kept at either -20°C or 4°C.
Few Mothers Meet Breastfeeding Goals, Study Shows - 8/5/04 - Only 14 percent of U.S. mothers exclusively breastfeed their babies for the minimum recommended six months, according to government data released on Thursday.
I personally find this statistic incredibly shocking. Breastfeeding is arguably the most important way to protect a baby's health, yet our healthcare system is doing so little to support it. We have routine separation of mothers and babies in hospitals and the pushing of all sorts of interventions that are harmful to the breastfeeding relationship but are supposedly done for the baby's own good. I don't think so!
In homebirth practices, the breastfeeding rate is over 95%. These
lucky babies will get immeasurable benefits beyond the 20% reduction in
mortality. Why doesn't our healthcare system support midwife-attended-homebirth
as the surest way to protect a baby's health?
It still amazes me that hospitals cannot provide breastfeeding support
24 hours/day for such a life-saving matter.
But nobody makes money off of healthy babies. This is no exaggeration.
I recently attended a CIMS Forum and was talking with someone about the
title of the talk - "Economic Disincentives for Mother-Friendly Care,"
the woman said that they had closed the highly successful lactation center
at her hospital. When she asked a hospital admin why, that was his reply.
Report warns of continuing violations of code on breast milk substitute marketing - [BMJ 2004;328:1218 (22 May)] - "[T]he Switzerland based company Nestlé was responsible for more violations than any other company,"
http: of information about the worldwide boycott, and they have a list of Nestlé subsidiaries, including the obvious ones like Nescafe, Nesquik and Nestea, but also including some surprising ones - Carnation, Alcon, Purina and Friskies. Breastfeeding.com offers a great handy visual list of Nestlé affiliates.
If I can boycott Nestle, so can you!
If you need more motivation to boycott Nestle, then read breastfeeding.com's Stuff That Will Make You Mad
"Mr Ian Smith of York, gave his account of the company's ethics: "As
one the members of Synod from York, where we have a significant Nestlé
presence, I was invited, before the last debate on this subject in 1994,
to meet some of their directors to discuss the issue. At that time they
freely admitted that they were the market leaders of a trade that was being
mishandled in some parts of the world. I observed that this resulted
in many thousands of infant deaths. The response was that if they didn't
sell the product someone else would. We've heard that line with regard
to landmines recently: In other words, it's better that they're killed
by our products rather than someone else's. Nestlé admitted that
the business has its unethical side, but they still push it hard. They
say they will stop - if others do too."
Feedback:
"People need to understand that when they're deciding between breastmilk
and formula, they're not deciding between Coke and Pepsi... they're choosing
between a live, pure substance and a dead substance made with the cheapest
oils available." -Lactation Consultant Chele Marmet
Some wonderful articles by Sarah J. Buckley, MD, from the section on Mothering - Care of the Newborn at Women of Spirit
Research in human lactation is sometimes rather limited by a shortage of eligible volunteers. This registry has been developed to provide the scientific community with a registry of potential volunteers for studying human lactation under special circumstances. These circumstances include certain medical conditions, problems with lactation, and use of specific drugs during breastfeeding. Women who are currently breastfeeding, and/or women planning to breastfeed after delivery, are included in this registry.
They are looking for moms with:
Hepatitis C
Hepatitis B
Cystic Fibrosis
"Suspected Yeast Infections of Nipple"
Insufficient Milk Supple
Persistent plugged ducts (>3/week)
Polycystic Ovarian Syndrome
Milk coagulates on storage
Planned Pregnancy while lactating
Chronic breast pain
Raynaud's of the nipple
Breast implants
Breast reduction
Fibrocystic breast disease
Galactocele
Rusty-pipe syndrome
Pathological breast engorgement
Infant with PKU
Lactation failure of unknown origin
Growth faltering after 4-6 months
or who are taking :
Celexa (citalopram)
Enbrel (etanercept)
Fenugreek
Flagyl (metronidazole)
Interferons (Betaseron, etc)
Lamictal ( lamotrigine)
Lithium
Milk thistle
Motilium (domperidone)
Neurontin (gabapentin
Paxil (paroxetine)
Prilosec (omeprazole)
Prozac (fluoxetine)
Reglan (metoclopramide)
Relafen (nabumetone)
Ritalin (methylphenidate)
Sage
St. John's Wort
Vioxx (rofecoxib)
Zoloft (sertraline)
Gerber has a 24-hour breastfeeding hotline with a Lactation Educator
- 1-800-4-GERBER, i.e. 1-800-443-7237
|
The International Lactation Consultant
Association (ILCA) is the professional association for International
Board Certified Lactation Consultants (IBCLCs) and other health care professionals
who care for breastfeeding families.
How to Nurture a Mother - Mothers
need to be nurtured so they can nurture their newborn. A mother who
isn't resting and eating/drinking well is more likely to have breastfeeding
problems. If you're trying to help a family member or friend with
breastfeeding issues, start with bountiful nurturance.
Dr. Jack Newman is perhaps the best expert on breastfeeding. He and Teresa Pitman have co-written The Ultimate Breastfeeding Book of Answers : The Most Comprehensive Problem-Solution Guide to Breastfeeding
Dr. Newman's Breastfeeding Handouts by Dr. Jack Newman
Breastfeeding - Why does something so natural cause so many problems? Session One: Latching On.
Is
baby getting enough milk? Breastfeeding Session Two
The
CDC Guide To Breastfeeding Interventions offers guidance to policy
and program professionals in selecting promising breastfeeding promotion
and support activities. [June, 2005]
Efficacy
of breastfeeding support provided by trained clinicians during an early,
routine, preventive visit: a prospective, randomized, open trial of 226
mother-infant pairs.
Labarere J, Gelbert-Baudino N, Ayral AS, Duc C, Berchotteau M, Bouchon
N, Schelstraete C, Vittoz JP, Francois P, Pons JC.
Pediatrics. 2005 Feb;115(2):e139-46.
This study provides preliminary evidence of the efficacy of breastfeeding
support through an early, routine, preventive visit in the offices of trained
primary care physicians. Our findings also suggest that a short training
program for practicing physicians might contribute to improving breastfeeding
outcomes. Multifaceted interventions aiming to support breastfeeding should
involve primary care physicians
The Milky Way, the newsletter of MOMS
Making Our Milk Safe (MOMS), the
parent organization
Falling
in Love: The Chemistry of the First Breastfeed
Breastfeeding
and CranioSacral Therapy: When It Can Help by Dee Kassing, BS, MLS,
IBCLC
Breastfeeding Foundations
for Nurses and Midwives - a fantastic online course from Australia.
First-Time
Mothers at Greater Risk of Breast Abscess [Medscape registration is
free]
The
deadly influence of formula in America by Dr. Linda Folden Palmer [A
Natural Family Online Special Report:]
The World Alliance for Breastfeeding
Action (WABA) is a global network of individuals and organisations
concerned with the protection, support and promotion of breastfeeding.
Excerpt
from Nursing the Caesarean Born, by Michel Odent, MD - Midwifery
Today Issue 69
Nursing Family Newsletter's
Resources and Links
Breastfeedingonline.com
hopes to help empower women to choose to breastfeed and to educate society
at large about the importance and benefits of breastfeeding. - the web
site of Cindy Curtis, RN, IBCLC!
Latching
and Positioning Resources from kellymom.com. Great set of Latch-on
pictures with description
The World of Latch-On: One Leader’s Journey by Diane Wiessinger, MS, IBCLC
"Watch
your language!" By Diane Wiessinger, MS, IBCLC
nursingmother.com now has
online
How-To videos so that you can see what it looks like when the baby
is on right and what it looks like when you have it wrong.
The International
Lactation Consultant Association offers a great document - Evidence-based
Guidelines for Breastfeeding Management During the First Fourteen days
(1999) - this is a terrific document available as a FREE download. The
guide provides 24 key strategies to guide health professionals in providing
optimal care to mothers and infants during the crucial first 14 days.
[Another link to this same document.]
Milky Way Press's Breastfeeding
Basics and Beyond(TM) series: Reading
Your Baby's Body Language and Breastfeeding's
Number One Question:How Will I Know My Baby Is Getting Enough Milk?by
Beverly
Morgan, Lactation consultant, lactation educator, author, speaker.
Breastfeeding Resources from
bf.marie.org
Best
practice guide to common breastfeeding problems from Australia
Breastfeeding
Tips, excerpted from Pregnancy
Tips, by Gail Dahl
Feeding
Frenzy
How big business and politics conspire against breastfeeding mothers
by Maureen Turner - April 15, 2004
IUDs:
Great Contraceptive, But Not For Nursing Moms from Dr. Dean Edell
Medications and Lactation: What PNPs Need to Know [Medscape registration is free.]
"Breast milk has consistently been confirmed to provide infants and
children with unique, species-specific nutrients that are ideal for infants'
immune protection, growth, development, and emotional well-being. Few maternal
medications are contraindicated for lactating mothers and their breastfeeding
infants "
Breastfeeding Pharmacology
- from the web pages of Dr. Tom Hale, author of Medications and Mothers’
Milk
Breastfeeding
Difficulties from ivillage.com
The Medical Supply House carries a diverse product line, including breast pumps and specialty feeding devices, such as the Hazelbaker™ FingerFeeder. (The FingerFeeder allows baby to be in control and pace the feed. It is the only special feeding method that provides the touch of the human skin. [Ed: Although you would want to be really sure the human finger doesn't carry yeast! You don't want to add thrush to an already difficult situation!])
Gerber has a new Massaging Manual Breast Pump
Encouraging Patients to Use a Breast Pump (after returning to work) - great article from Medscape [Medscape registration is free]
Pumping Moms Information Exchange
White River Concepts - "Medical study rates WRC pump equal to nursing babies for stimulating milk production" - An unusual pump for people who don't letdown to the usual top-of-the-line hospital pumps. It uses compression as well as suction and is much more like baby.
Breast Pump Comparisons - this compares features of some major brands.
Medela has a web page on how to find out which breastpump is right for you.
http:
http:
Motherwear wants to help women
like you find the support and confidence to breastfeed whenever and wherever
your babies are hungry. Free breastfeeding guides, along with clothes that
were designed and made with you and your baby in mind.
Mother's Nature carries
Nursingwear, Nursing Bras (Medela, Bravado), Medela Breastpumps and Accessories,
Breastfeeding Accessories, Over the Shoulder Baby Holder Sling, Cloth Diapers,
Toys, Books for Pregnancy and Childbirth. There are also new Auction Pages!!
NURTURED BABY Organic Cotton
Bras, Bravado Nursing/Maternity Bras and Maternity Underwear
Clothes for
the Nursing Mother
Australian Breastfeeding
Association - formerly the Nursing Mothers' Association of Australia
Breastfeeding.com - We are
here to give you the best in breastfeeding information, support, humor,
news, supplies, advocacy, stories, attitude and more. [This site
has good general breastfeeding information. They will also send you a lovely
poster with the top 12 reasons to breastfeed.]
BestFed.com - "Breastfeeding
for as long as your child wants to is probably THE most important thing
you can do for the health and wellbeing of your child after birth."
1998 Breastfeeding
Resource Guide - San Diego County Breastfeeding Coalition
Lactnet Archives-http:
NURSING MOTHER’S COUNSEL (Fort Wayne,
Indiana, USA - Local Chapter)
Breastfeeding
and Parenting Resources on the Internet
Management
of nipple pain and trauma - by Wendy Nicholson RM IBCLC 5.4.98
Joy Johnston's Resource
Centre - Midwifery Care and Breastfeeding - Lactation consultation
Baby-friendly Hospital
Initiative (launched by WHO and UNICEF in 1991) - The BFHI, sponsored
by the World Health Organization and UNICEF, is a world-wide effort to
improve breastfeeding rates. Based on the ten steps to successful breastfeeding,
the initiative encourages hospitals to examine their practices, make the
appropriate changes and then apply for recognition as a Baby Friendly Hospital.
World
Health Organization (WHO) on Breastfeeding
Kathy Dettwyler's Thoughts
on Breastfeeding and her supporting
medical references
INFACT Canada - The Infant Feeding
Action Coalition - Canada home page
The Parent-L Breastfeeding
Resources Page:
The Bright Future Lactation Resource
Centre is an education and motivation resource for Lactation Consultants
and others providing parents with infant feeding information.
Fenugreek:
One Remedy for Low Milk Production By Kathleen E. Huggins, RN, MS
How to Know a Health Professional is not Supportive
of Breastfeeding
The purpose of MOBI (Mothers
Overcoming Breast feeding Issues) is to give women a place to discuss
their emotions over not being able to breast feed successfully.
The Human Milk Banking Association
of North America, Inc. represents all of the North American human milk
banks which collect, pasteurize, and distribute donated mother's milk.
Project "Got Breastmilk?"
- beautiful photographs of breastfeeding mothers and babies
Smoking
leaves taste in breast milk -U.S. study
Effects of Mag. Sulfate on Breastfeeding
I've heard that in India, breastfeeding mothers are encouraged to follow
a special diet for the first 8-12 weeks, as food eaten during that time
has a lifelong influence on the baby's tastes. (Please
contact me if you have more information about this. Thanks.)
Veg Pregnancy
& Breastfeeding - from vegetarianbaby.com
Midwifery and Breastfeeding
Bumper Stickers - Texas Sticker Company & Label Exchange
See also: Birth Trauma and Breastfeeding
Difficulties
It's important to consider birthing practices that affect breastfeeding
because they have a strong effect on the baby's ultimate health:
Drugs
There's a great book about this, Impact
of Birthing Practices on Breastfeeding: Protecting the Mother and Baby
Continuum by Mary Kroeger. You can also get this book from the
La
Leche League Store.
The breastfeeding rates in my homebirth practice are close to 100%,
and if you consider how significantly this increases birthing safety, it
makes homebirth significantly safer than hospital birth.
Alta
Vista search for information about "birthing practices" AND breastfeeding
Changing
hospital practices to increase the duration of breastfeeding. - an
oldie but a goodie!
WHO/UNICEF
Baby-Friendly Hospital Initiative
Hospital
Support for Breastfeeding and Associated Outcomes
In this study, 89.7 percent of babies were fully breastfeeding at
six weeks.
Outcomes
of planned home births with certified professional midwives: large prospective
study in North America [Full-text
article]
Conclusions: Planned home birth for low risk women in North America
using certified professional midwives was associated with lower rates of
medical intervention but similar intrapartum and neonatal mortality to
that of low risk hospital births in the United States. [NOTE - CPMs
are equivalent to Licensed Midwives in California and some other states.]
What is the single most positive contributing factor for the successful
establishment of breastfeeding?
Homebirth.
I assume the gentle birth, the avoidance of tubes down the baby's throat,
the time to allow for baby-led nursing, and the general calm and quiet
help a lot. But the studies say it's the simple fact that the midwife shows
up at the home at 24 hours, 3 days, 5 days, whatever it takes to get that
mom and baby nursing well.
This is the sort of thing I fret about when I hear people talking about
extending hospital stays for new moms and babies.
I'm thinking - get them out of that hospital and away from the infection
threats as soon as possible. Instead, use the money from the cost of an
extra day in the hospital to pay for three home visits from a birthing
professional and a week's worth of household help. This would go a long
way towards helping breastfeeding.
The following information is from Volume 3, Issue 3 of Research Summaries
for Normal Birth, July 2006, from the Lamaze
Institute for Normal Birth:
Summary: The first of a series of new pediatric growth charts
have been released by the World Health Organization (WHO). The new growth
standards were developed to replace existing pediatric growth charts based
on growth patterns in predominantly formula-fed populations. Beginning
almost a decade ago, the WHO undertook a detailed and elaborate statistical
study, sampling thousands of infants from eight ethnically diverse, economically
stable nations where at least 20% of women had access to breastfeeding
support and followed WHO infant feeding guidelines. The healthy, term infants
who participated were followed by trained researchers biweekly for 2 months,
monthly up to 12 months, and bimonthly up to 24 months. An additional sample
of children was followed up to 71 months. Breastfeeding support was provided
as needed. Data were collected on infant growth patterns and achievement
of motor skills.
The resulting infant growth standards offer pediatric providers and
parents the first evidence-based information on how children should grow
under optimal conditions. The researchers found that there was very little
ethnic variability in average growth or achievement of motor skills, suggesting
that poverty and sub-optimal nutrition are responsible for previously observed
regional variability in infant growth.
Significance for Normal Birth: The WHO infant growth charts are
an important step in positioning breastfeeding as the norm and reversing
decades of erroneous advice to parents of breastfed infants who were told
that their infants were failing to thrive because they gained weight more
slowly than formula fed infants. Now, more formula fed babies will be seen
to “fall off the curve” by gaining weight too rapidly, an important predictor
of childhood obesity.
The results of the WHO Multicentre Growth Reference Study provide solid
evidence that breastfeeding contributes to the optimal growth and motor
development of infants. Interventions in normal birth, including cesarean
surgery and unnecessary separation of mothers and babies impede women’s
ability to initiate successful breastfeeding with their newborns thereby
contributing to less than optimal infant growth and development.
Average
Growth Patterns of Breastfed Babies from kellymom.com, with a great
list of related references and resources.
"The from the CDC Growth Charts FAQ]
LactMed:
A New NLM Database on Drugs and Lactation is a peer-reviewed and fully
referenced database of drugs to which breastfeeding mothers may be exposed.
The database was produced by the National Library of Medicine as part of
the Toxicology Data Network. Among the data included are maternal and infant
levels of drugs, possible effects on breastfed infants and on lactation,
and alternate drugs to consider. The database is searchable by drug name.
Breastfeeding
and Drugs - from motherisk.org
Drugs
in Pregnancy and Lactation from Harbor UCLA Medical Center
CARE Northwest gives free telephone advice to pregnant and breastfeeding
women about the possible effects of drug and chemical exposure. Call Monday
through Friday, 8 a.m.-4 p.m.: 888-616-8484.
What about drinking alcohol
and breastfeeding? from La Leche League
Breastfeeding
And Alcohol from breast-feeding-information.com
The Breast Milk Cocktail -- the author
finds contradictory info on alcohol and caffeine By Elizabeth Agnvall
Beer, Alcohol And Breastfeeding
Alcohol,
breastfeeding, and development at 18 months. [ Full
text ]
DISCUSSION: We were unable to replicate the earlier deficit in motor
skills associated with lactation alcohol use. One reason may be that the
dose of alcohol reaching the lactating infant is small, and tests of infants
and toddlers have limited ability to pick up small effects. Studies of
older children may resolve the question of the safety of drinking while
nursing.
Breastfeeding
and alcohol from Britain's National Childbirth Trust:
The legal drink driving limit in the UK is 80mg of alcohol per 100ml
of blood.
100ml is a decilitre so this means you would have to be between 3 and
4 times the legal limit for driving before the alcohol you were drinking
had significant effects on your baby....and actually feeding at the time
you were affected, too.
Alcohol reaches the breastmilk shortly after it reaches the bloodstream
- so fairly quickly, in other words, but in dilute quantities. Hale says
'the absolute amount transferred into milk is low'.
You can be sure your breastmilk is clear of alcohol when your bloodstream
is clear of it, and the usual guide for this is that the body processes
alcohol at a rate of one and a half to two hours per unit.
Just as your body deals with alcohol, and any effects of it are temporary
(apart from people who drink chronically over years, whose brain and liver
are affected) , your baby's body deals with the very small traces of alcohol
in the milk.
There are reports in Hale of effects on milk supply, let down and taste,
but these will be temporary." A
new paradigm for depression in new mothers: the central role of inflammation
and how breastfeeding and anti-inflammatory treatments protect maternal
mental health
Breastfeeding fights depression
MedWire News: Breastfeeding can help new mothers fight depression, research
shows.
Kathleen Kendal-Tackett (University of New Hampshire) says that depression
is common among new mothers, and affects anywhere from 10 percent to 20
percent of postpartum women.
"Since depression has devastating effects on mother and baby, it's vital
that it be identified and treated promptly," she adds.
Kendal-Tackett says that new mothers experience an increase in inflammation
due to high levels of pro-inflammatory cytokines.
Common experiences associated with new motherhood such as disturbed
sleep and postpartum pain can also act as stresses that cause pro-inflammatory
levels to rise, she says.
Breastfeeding can reduce women's stress levels so that their inflammatory
response systems remain inactive. This then reduces their risk of depression.
But Kendal-Tackett notes this is only true when breastfeeding is "going
well."
"When breastfeeding is not going well, particularly if there is pain,
it becomes a trigger to depression rather than something that lessens the
risk."
She concludes: "Mother's mental health is yet another reason to intervene
quickly when breastfeeding difficulties arise."
Higher Concentration
of Vitamin C in Breast Milk Linked to Lower Rate of Infant Atopy
CME
Vitamin
C in breast milk may reduce the risk of atopy in the infant.
"If you breast-feed for at least 4 months, your child will experience
one-third the risk of hospitalization for lower respiratory disease,''
lead author Dr. Virginia Bachrach, a community pediatrician in Palo Alto,
California, told Reuters Health. The protection seems to last for the first
year of life, Bachrach noted.
Bachrach said that 6% of all US infants less than 1 year of age are
hospitalized annually for lower respiratory tract disease, which elevates
their risk for later illnesses such as asthma and creates a costly healthcare
burden.
Study:
Breast Feeding Cuts Infant Death 20 Percent [5/2/04] - Breast-fed children
in the United States are 20 percent less likely to die during the first
year of life than whose who are not nursed.
A response to Target's response:
I understand that you think you were being "fair" in presenting "both
sides" of the breastfeeding vs. bottle feeding question. Unfortunately,
you neglected the "side" that is most important - the baby's.
A newborn has an immature immune system that is incapable of mounting
an adequate defense against many germs, especially the more virulent, antibiotic-resistant
bacteria. Nature intended that the breastfeeding mother be an extension
of the baby's immune system, providing vital antibodies and macrophages.
Every newborn relies on breastfeeding to provide a defense against life-threatening
infections.
Next time you wish to expound on the alleged benefits of bottle feeding,
I hope you'll do so from the point of view of the person most affected
- the baby.
The FDA's
"Breastfeeding Best Bet for Babies":
Rachael's page on "Why Breastfeeding
is Important":
This contains references to research showing, among other things, that
BF'd children are smarter, healthier, have less risk of SIDS etc,
Preliminary Growth
Charts for Breastfed Babies
USDANEWS/Article5/August
1997 - The Ideal Infant Food - "Loving Support Makes Breastfeeding
Work." USDANEWS GREEN LINE VOLUME 56 NO.7 - AUGUST 1997
UPI Summary of Breastfeeding Advantages
Advantages
of Breastfeeding Links - This page was written in the interest of supporting
and promoting breastfeeding for all moms and babies. UNICEF states that
1 million babies die each year as a result of being fed artificial formula,
some die from diarrhea and other intestinal illnesses , some die from malnutrition
because their families can not afford to purchase formula, and some die
from the illnesses that formula fed babies are more likely to contract.
Breast Milk May Reduce Risk of Schizophrenia
Although this study was published in 2006, it appears that it was based
on data collected in 1979; it is hard to know whether the data collection
standards from 1979 would hold up against today's standards.
Effect
of breast feeding on intelligence in children: prospective study, sibling
pairs analysis, and meta-analysis
Conclusions Breast feeding has little or no effect on intelligence in
children. While breast feeding has many advantages for the child and mother,
enhancement of the child's intelligence is unlikely to be among them.
On the other hand, this 2004 study showed that although parental intelligence
is also correlated, it appears that breastfeeding, in and of itself, also
increases intelligence.
Influence
of breast-feeding and parental intelligence on cognitive development in
the 24-month-old child.
"The results of multiple linear regression analysis showed that infants
breast-fed for longer than 4 months scored 4.3 points higher on the mental
development scale than those breast-fed for less time. No differences were
found in psychomotor development as a function of feeding regimen or duration.
The positive linear correlation observed between parental IQ and mental
development scores at 24 months was also statistically significant (mother:
r = 0.39; p < 0.001; father: r = 0.43; p < 0.001). It may be concluded
that breast-feeding for longer than 4 months has a positive effect on the
child's mental development at 24 months of age. Parental intelligence also
appears to influence cognitive development."
Breastfeeding
in Whose Public? by Peggy O'Mara, editor of Mothering
Magazine
A Current Summary
of Breastfeeding Legislation in the U.S. - a state-by-state guide to
breastfeeding laws in the U.S. from La Leche League.
California Governor Signs Bill Assuring Right
to Breastfeed in Public
Nursing Bras/Nursing Clothes
Women seem to recommend the following bras as good for nursing:
Great Site with Lots of Information and Support
Promotion of Mother's Milk, Inc. (ProMoM)
is a nonprofit organization dedicated to increasing public awareness and
public acceptance of breastfeeding, including 101
Reasons to Breastfeed Your Child. This site is the new home of J.
Rachael Hamlet's Breastfeeding Advocacy Page.
NURSING MOTHER’S COUNSEL National
Organization
This site has some really terrific articles on breastfeeding.
Kathleen Huggins is a Director of the Breastfeeding Clinic at San Luis
Obispo General Hospital, CA. She is the author of The Nursing Mother's
Companion and coauthor of The Nursing Mother's Guide to Weaning.
by Jack Newman, MD.
New England Journal of Medicine, Nov., 1998
Effects of Birth Practices on Breastfeeding
Cesarean
Separation of mother and baby
Circumcision
Homebirth Most Significant Factor in Successful
Breastfeeding
Kenneth C Johnson, senior epidemiologist, Betty-Anne Daviss, project
manager
BMJ 2005;330:1416 (18 June), doi:10.1136/bmj.330.7505.1416
Growth Charts for Breastfeeding Babies
New Pediatric Growth Charts Reflect Breastfeeding as the Norm
Acta
Paediatrica: WHO Child Growth Standards
Breastfeeding and Alcohol
Little RE, Northstone K, Golding J; ALSPAC Study Team.
Pediatrics. 2002 May;109(5):E72-2.
"Hale (Dr Thoms Hale in Medications and Mothers Milk, the international
textbook on this topic, all research based) says the mother needs to have
a blood level of 300 mg alcohol per decilitre of blood before her infant
shows significant side effects (mainly sedation).
Breastfeeding Benefits
Kathleen Kendall-Tackett
International Breastfeeding Journal 2007, 2:6
doi:10.1186/1746-4358-2-6
08 May 2007
International Breastfeeding Journal 2007; 2: 6
Hoppu U, Rinne M, Salo-Vaananen P, Lampi AM, Piironen V, Isolauri E.
Eur J Clin Nutr. 2005 Jan;59(1):123-8.
CONCLUSION: A maternal diet rich in natural sources of vitamin C during
breastfeeding could reduce the risk of atopy in high-risk infants.
Breast-Feeding Cuts Risk of Respiratory Disease
[Oct., 2001] Healthy children who are breast-fed are one-third less
likely to develop a lower respiratory tract infection compared with bottle-fed
babies, according to a review of the medical literature presented here
Monday at the American Academy of Pediatricians' annual meeting.
Breastfeeding as Birth Control
September, 1999 - [Medscape
article] The World Health Organization asserts in the September issue
of Fertility and Sterility that "...the lactational amenorrhea method is
a viable approach to postpartum contraception." [NOTE that co-sleeping
will significantly increase the effectiveness as it encourages the baby
to nurse during the night; some say that babies must nurse as often as
every six hours in order for LAM to be effective.]
The Target Flap - December, 1998
Target's Lullaby Club advertisement
carried
an editorial about advantages of bottle feeding vs. breastfeeding.
This website shows a large ad by TARGET stores outlining the many advantages
of bottle-feeding. ARGH!!! A couple advantages it states are
how bottle-feeding doesn't tire mom or baby, and that it may help the baby
sleep through the night, how dad can help in feeding, how you can still
eat spicy foods, how since it takes longer to digest formula, baby doesn't
need to be fed often (that's like saying that since disposable diapers
are so absorbent, babies can sit in their own waste without leaking for
many more hours than before!!!).
The newborn baby has only three demands. They are warmth in
the arms of its mother, food from her breasts, and security in the knowledge
of her presence. Breastfeeding satisfies all three.
Dr. Grantly Dick-Reed
From: C-upi@clari.net (UPI / LIDIA WASOWICZ, UPI Science Writer)
Subject: Health Today [Jul 28]
Date: Mon, 28 Jul 1997 0:50:49 PDT
Breastfeeding Protects Against Ear Infections: A study shows babies who
drink from the breast rather than the bottle are less likely to develop
ear infections. The study by the National Center for Chronic Disease Prevention
and Health Promotion shows babies fed nothing but mother's milk were 70
percent less likely to develop ear infections in their first year of life
than infants who got formula only. The authors say this study is very important
because only 53 percent of U.S. women breastfeed their children. That means
47 percent of babies are at increased risk of ear infections.
Effect of breast feeding on intelligence
"Setting: 1979 US national longitudinal survey of youth."
Geoff Der 1*, G David Batty 1, Ian J Deary 2
BMJ, doi:10.1136/bmj.38978.699583.55 (published 4 October 2006)
Gomez-Sanchiz M, Canete R, Rodero I, Baeza JE, Gonzalez JA.
Clin Pediatr (Phila). 2004 Oct;43(8):753-61.
Breastfeeding Rights
Vitamin D in Breastmilk
Vitamin D
Dr. Mercola's comments
on the issue of Vitamin D in breastmilk - Pregnant women have an added
reason to get their vitamin D levels checked. As the study shows, if a
breastfeeding woman is deficient in vitamin D, then her breast milk and
breastfeeding baby will be too.
Hollis and Wagner announced their lab has determined that lactating
mothers need at least 3,600 IU a day of cholecalciferol (the natural form
of vitamin D) to maintain their own and their infant’s vitamin D levels.
2,000 IU was inadequate. Only when Hollis and Wagner gave lactating mothers
3,600 IU of cholecalciferol did the mother have enough vitamin D to maintain
their own and their infant’s blood levels. 3,600 IU of vitamin D is about
10 times what the federal government says lactating women should get and
is almost twice what the federal government says may be toxic.
From what I have learned it is not necessary to supplement your diet
with vitamin D alone. As long as you are nursing your baby, it is however
important to continue taking your prenatal vitamins. What I recommend to
clients is to also ensure eating ample varieties of foods that are high
in vitamins and minerals. A food is an immediate source of nutrition and
should not be regarding as only filling your belly when your hungry. Foods
such as dairy products- milk, cheese-, eggs, fatty saltwater fish (such
as halibut and tuna), oatmeal, sweet potatoes, vegetable oils and dandelion
greens. Herbs high in vitamin D are nettle, alfalfa, horsetail and parsley.
Although, I do not recommend taking parsley at all while nursing unless
you wish to decrease your breast milk production. Another very simple way
of implementing vitamin D into your system is just a few minutes of sunlight
a day. When the skin is exposed to the sun's ultraviolet rays, a cholesterol
compound in the skin is transformed into a precursor of vitamin D.
Vitamin D Supplementation
of Breast-Fed Infants [Medscape registration is free]
Vitamin supplements in children - Are they necessary? Are they good?
A study published in Pediatrics this month suggests that multivitamin supplementation
may be associated with an increased risk of babies developing asthma and
food allergies. [More information about Supplements
for Kids]
Delivery Self Attachment
by Lennart Righard, M.D. - This video depicts a newborn's ability at
birth to crawl up to a breast and ATTACH HIMSELF UNASSISTED!
OK!!! I have FIRST-hand experience with this. Sometime last year in an issue of Mothering magazine, there was an entire article on the phenomenon....even with pictures. It was really neat. I remember showing it to DH and saying....wow...that is really cool, but at the SAME TIME I told him....well...I am so excited about other things RIGHT after the birth that I am not really interested in repeating the experiment......but it really is neat.
WELL....after my baby was born....we were all laughing and crying and I was talking with the MW's when they got there and I didn't really notice, but my baby WAS crawling/inching her way along up my abdomen. I DID notice because all of the sudden I said "HEY!!!" and I looked down and she had ATTACHED her mouth to MY NIPPLE and was SUCKING!!! It was the COOLEST thing!!!
I think this happened because as this was my first HB, no nurse or OB was RUSHING to cut the cord and take her off of me. And secondly, this was an unassisted and there WERE NO MW's for about 10 minutes, so I said to DH and everyone, let's just keep her on my belly with the warm towels on top of her and then when the MW's get here THEY can cut the cord and all. So...my baby was on my belly for a significant amount of time....and I think THAT is what enabled the experiment to be a success even though we weren't even trying!!!
One other significant thing I remember from the article is that it is
very important if you want to repeat the experiment is that you do not
wash the baby's hands at ALL. They say that the baby needs to be
able to smell the amniotic fluid on their hands and that the nipple smells
like amniotic fluid too and that is why they are attached to it.
Lying Down May Help Breastfeeding
"A study of 40 mothers breastfeeding in different positions found that
babies' natural reflexes kicked in more easily when the mothers were lying
down. . . . Dr Suzanne Colson, senior midwifery lecturer at Canterbury
Christ Church University, advises women on a technique called biological
nurturing where the mother lies down and lets the baby lie on its tummy
on top of her. . . . She spotted 17 reflexes in babies when they were breastfed
lying down, including reflexes normally associated with other mammals who
feed their babies in this way. Breastfeeding in a sitting-up position only
promoted the three normally seen reflexes - routing, latching and sucking.
Mothers who breastfed lying down seemed to have more success and, although
the majority of women in the study had initially reported problems with
breastfeeding, after using the technique all the women continued breastfeeding."
Rachael's page on "Breastfeeding
and Returning to Work":
Human Milk
Storage Information from LLL
Herbal
Galactagogues Compiled by Gretchen Humphries [March 02, 2000]
This makes 2-3 quarts - enough for a week or two unless correcting a real problem with supply. Steep in a closed jar at overnight. I like to give moms a little baggy of it for mental support that first time they think "ACK, no milk". The few that really need it buy more on their own.
I don't add raspberry leaf - I think someone mentioned it counteracts milk-supporters to some degree. Anyone else heard this?
I suppose you could take BT in capsule form if more was needed, but have never encountered that degree of problem.
To increase milk try any of these (or combo): fennel seed tea or capsules,
hops tea (or good quality non-alcoholic beer), two 500-mg capsules morning/evening
of vitex (chaste berry), blessed thistle, aniseeds, nettles, raspberry
leaf tea/capsules, fenugreek, nurse often, marshmallow root, alfalfa, brewer's
yeast pills, zinc, selenium, vit E, iron, soy, wild yam, and a lot of fruits
and vegetables.
I've had moms use Blessed Thistle to increase the fat content of breastmilk
and had it work wonders.
"A new mother may experience great stress if her new baby has difficulty
with breastfeeding. This stress often becomes part of a vicious cycle,
further exacerbating the problem. Homeopathic Silicea (taken by Mom and
imparted to baby through the breast milk) helps the delicate infant who
needs appetite stimulation, and helps with watery stools and vomiting after
nursing." For other tips on homeopathics for nursing and newborn
care, see the EMAZING.com
archives of the Homeopathic Health Tip of the Day
Herbs to Avoid
During Lactation from HerbLore (scroll
down the page)
Spirulina is fantastic for nursing mothers! It is filled with chlorophyll,
rich in protein, contains all 8 amino acids and has B12 (important source
for vegetarians). The chlorophyll nourishes blood (a precursor to breast
milk in Chinese Medicine) and helps remineralize the body--including calcium,
which is obviously lost during lactation & pregnancy. Spirulina helps
balance blood sugar and helps with energy and stamina. I recommend a product
called Pure
Synergy for all my patients including pregnant and nursing moms. There's
more in it than spirulina.
If a baby consistently prefers one side, it's worth considering the
possibility that they are having some pain when nursing on the other side,
possibly due to some residual birth trauma. Try a different hold
on the side they usually don't like, e.g. try the football hold, or sidelying
from the top breast, or lying flat on your back with the baby on your belly.
If the baby suddenly is interested in the breast that they previously avoided,
it makes sense to take them for a chiropractic or craniosacral evaluation.
This goes double for a baby who won't nurse well at all. Compressed
skull bones can make it painful to open their mouth wide enough to latch
on
I don't think that the problem that I'm going to post about is GBS because
these moms haven't had PROM or any of the other symptoms. But once in a
while and just this last week I had the experience again, are those darned
babies that refuse to nurse for hours after birth. Then the worry about
hypoglycemia, dehydration etc. It seems that you just can't get anything
down them at all. This last one seemed to thrust her tongue when anything
was put in her mouth. She wouldn't even take my finger. We really worked
with this one and finally but these babies every once in a while are what
make me want to pull my hair out. You just can't get them to nurse for
anything.
I agree, this is a really tough situation. I have had similar difficulties with babies in the past. I have not seen it as the result of any infectious process. I generally try the suggestions below. Perhaps this info will help you out next time.
Sometimes these babies seem to have gotten into the habit of sucking something like a fist or the side of their hand in utero ( I check their hands for a little blister like area) which seems to make them prefer to suck with the tongue thrust, and resist anything (finger, breast) deeper into their mouth. It takes quite a bit of patience and gentleness to get them to accept the finger. I try gentle stroking of the face and lips to stimulate baby and then try 'tongue walking' -walking my finger slowly from tip towards back of tongue drawing it down and forward with pad of my index finger.
Sometimes they are just what is sometimes called an 'aggressive non-nurser'
- they arch away from the breast and scream and refuse to nurse. With these
babies, I try to gently curl them into 'C' shape which is neurologically
more conducive for feeding. Then I would try the facial stroking- starting
from the nose, and stroking out towards cheek and then down towards chin-
and from midline upper lip- around and down too chin and lower lip. Then
try positioning them in the clutch/football hold for nursing- to maintain
the 'C' curl. See if this helps.
When I worked as a hospital nurse, I used to see a great deal more of what you are describing. Some babies are born reluctant nursers. Sometimes the circumstances of birth can play a role too, as in a very long, difficult birth or sometimes, even an extremely rapid birth.
Babies who are deeply suctioned at birth (sometimes necessary if there is mec) can develop oral aversions. Also some kiddos seem to develop habits in utero that contribute to nursing problems. Last April, we had a little one born who, first of all, was somewhat depressed and needed some active resuscitation post-birth, then had some tachypnea and transient nasal flaring and grunting. Things settled down quickly but the baby did not nurse for a good 12 hours post-birth. Fortunately, the parents gave birth at my partners house, and stayed the night because they were so tired, and this allowed us more time to work with them. Finally, the other thing I discovered the following morning, was that the baby had developed the habit of sucking on her lip and was very resistant initially to the breast.
When I have babies who don't exhibit interest in nursing in the first few hours, I always look for reasons (difficult birth, any signs of distress, maybe too much environmental stimuli, and so on). I encourage skin to skin contact and consistent gentle efforts to offer to nurse. As far as getting babies to take my finger, I have found that it is helpful to be very gentle about this...... I tickle the lips with my finger just as I would have mom do with her nipple, and let the baby set the pace with accepting my finger. This seems to work well most of the time.
Finally, if baby continues to be reluctant and it is getting on to be
24 hours, I try to get mom set up with a hospital grade electric breast
pump to start stimulating milk production, continue with skin to skin,
etc. If mom can get some colostrum, it can be cup fed to the baby or an
eye dropper can be used. If I can't get the mom to pump or get any colostrum,
I would consider using formula at that point in a cup (just small amts).
Sometimes, once the baby gets a little something in his or her tummy, they
figure out that they want to eat.....
I wouldn't worry TOO much about them if all else seems normal. Some
babies just don't want to nurse till they get hungry and it really doesn't
hurt them to go for a while. (Remember the huge controversy in the 60s
about "early feeding", when it was considered unhealthy to allow feeds
before 24 hours?). If a baby is showing any signs of hypoglycemia - and
wont nurse or take a bottle - then you can correct it easily with a tiny
bit of syrup or Karo on your finger.
I would just keep an eye on these kids, keep attempting every couple hours. They might take a day or two to get the hang of life outside the womb where they have to work for their supper!
IF ALL ELSE IS NORMAL, they probably will become ravenous on day two
or three when the milk comes in...
This last baby that didn't nurse finally started at 18 hours. I had
the parents giving her sterile water w/sugar. This seemed to get her interested
and all is well now. No I don't remember in the 60's about the delayed
feeding. I think I was in high school and not even thinking about this.
But I'm glad to hear it. Thanks.
Slow weight gain has the potential to be serious...but with close monitoring
and good breastfeeding management it can be turned around. Mom and baby
can continue to have a happy nursing relationship.
You can boost baby's caloric intake using the settled fat from mom's own expressed milk. The mom can express some of that copious milk supply, leave it to stand then skim off the fat layer that settles out and mix it with a small portion of the thinner milk, this would supply baby with a great caloric boost to try and up the weights.
A mom with lots of milk is doing something right to keep the supply
going strong. I agree that baby should be encouraged to nurse more often
and as long as possible on the one breast as possible, only switching when
baby seems completely done and uninterested in "working" the breast. Offering
the second breast that will supply and easy "slurp" is good for a top off.
Just a little note of correction here, no baby should ever be given sugar water under any circumstance. If they are not nursing and you are simply concerned about dehydration, simple water is best. If they are not nursing or not nursing sufficiently, they should be given formula (by bottle, cup, syringe, finger, whatever). Giving a baby glucose water is like feeding them cocacola. Not good. It leads to destabilized blood glucose levels because they put out a lot of insulin when they first get the sugar and then can drop their blood glucose levels precipitously as they metabolize the sugarload. These kind of blood sugar surges and declines can lead to mild behavior changed (such as irritability and difficulty nursing -- just what you are trying to fix) all the way to coma and brain damage in a susceptible baby whose well meaning parents feed it too much sugar water.
The American Academy of Pediatrics stated a few years ago unequivocally that infants should never be fed sugar water. Regular water for dehydration prevention or to stimulate nursing is sufficient in most cases. A non-nurser needs whole calories such as that provided by pumped breast milk or formula, not the "empty" calories and sugar rush provided by glucose water.
If you are still not convinced, the next time you have to do a three hour glucose test on a woman, ask her how she feels an hour after the 100 gm glucose load on an empty stomach. Most of my clients say they feel flushed and lightheaded. Then ask them how they feel at the end of the test. Most of my clients say they feel tired and listless. Is this really what you want to put a newborn through?
I do not mean to sound harsh, I know that midwives who recommend sugar water are doing what they think is right, but I urge all of you who still recommend sugarwater to reconsider this advice and gather whatever information you need to convince yourself and you clients that pumped breastmilk or formula is best.
I cringe every time I enter the newborn nursery at my back-up hospital
and see the cases of glucose water. Can't seem to convince them.
With regards to giving a newborn sugar water, I attended a Perinatal
conference in Texas in 1996 and heard a speaker refer to just that! The
speaker said that research has shown that supplementing with oral sugar
water may actually delay the excretion of bilirubin in a newborn's immature
digestive system! I am so glad you brought this subject up!
During my training as an LC, we learned of the correlation between receiving IVs and poor latch (not just with narcotics). The excessive fluids the mom received can cause edematous nipples (which are usually not noticeable by one who doesn't know what they are looking for). So they explained the importance of getting a full birth hx on a mom with nursing difficulties. One thing to ask is if she was pitted (or had any IVs). With such a large, edematous nipple, latching is often more difficult for the baby. This usually takes 24-72 hours to resolve, but as we know, if there isn't help with poor latching the first day, nursing difficulties can be long-term. I think if a mom is aware of what the problem might be and is given tips to work with the issue, she is more likely to be armed to deal with the problem.
This helps us to remember that ANYTHING we do that interferes with the
nl process of birth may cause problems later, so we all need to choose
our interventions wisely and be prepared for the potential consequences.
I would never have thought of a pit IV as having problematic sequelae for
latching.
Thanks to Marsha Bearden RN, IBCLC, a lactation consultant in Alabama, who wrote to tell me that her web site offers the Niplette for sale!
Avent sent me a sample when I faxed them a request on my midwife letterhead. I can see that it would work well, and it's got some rave reviews on some of the lactation lists. Combined with the research, I'd say it's definitely worth a try. However, it is pricy - $50 retail.
The sample came with a brochure listing a toll-free number; it didn't work when I tried it, but here it is, just in case: 1-888-Niplette (647-5388). Their main number is 800-542-8368, and you can theoretically order the Niplette from that number. Good luck. The Avent America site has a Store Locator Page.
Most references to the Niplette appear to be British. I did find
some sites with pictures of the product in use: Here's a British
Avent site, a French
Avent site and a Dutch
site .
The "Niplette": an instrument for the non-surgical correction of inverted nipples.
McGeorge DD
Br J Plast Surg 1994 Jan;47(1):46-9
Inverted and non-protractile nipples are a common problem which cause psychological distress and interfere with a woman's ability to breast feed. A new instrument, the "Niplette", readily corrects the defect without the need for surgery. It is cheap and all patients found it comfortable and easy to use. Breast feeding is possible after treatment. The device should replace surgery in medical practice for this common condition.
Interesting articles from Lactnet about the Niplette:
Hoffmann's hypothesis, shells and Niplette
I have heard of the nipplette and it seems to work fairly well but is outrageously expensive. There is another product on the market that is better in my opinion. It is called Evert (?) and was invented by Edie Armstrong. You can reach her at: Edie Armstrong BSN, IBCLC, Fairfax, mailto:earmstr@erols.com
There is also an easy way to make something similar yourself: Take a 10cc syringe and cut off the end where the needle goes. A hacksaw works well. (Take off the needle first!) Take the plunger and insert it into the end you just cut off. The uncut end fits over most nipples. Have the mom place it over her nipple and gently have her pull back on the plunger. This pulls the nipple out very well and its cheap!
Another thing to do is have the mom use the Hoffman technique. Have the mom place her thumbs on the areola at 12 & 6 and gently pull her thumbs apart. Tell her to work all around the areola and do it 2-3 X a day. This helps break the adhesions that are holding the nipple in.
I have moms do these and using nipple shells starting about 30 weeks.
If you don't catch the inverted nipples until after the baby is born they
still work. Using the syringe right before the baby latches will really
help.
Treatment
of inverted nipples using a disposable syringe.
Kesaree N, Banapurmath CR, Banapurmath S, Shamanur K
J Hum Lact 1993 Mar;9(1):27-9
Seven mothers who had inverted nipples were helped to breastfeed their infants with the assistance of a simple device made from a 10 ml disposable syringe. These women were able to successfully breastfeed within one week. On follow-up, these mothers were able to sustain adequate breastfeeding.
Preparing
for breast feeding: treatment of inverted and non-protractile nipples in
pregnancy. The MAIN Trial Collaborative Group.
Midwifery 1994 Dec;10(4):200-14
CONCLUSIONS: in the light of the findings from this and a previous single centre trial, there is no basis for recommending the use of either Hoffman's nipple stretching exercises or breast shells as antenatal preparation for women with inverted and nonprotractile nipples who wish to breast feed. Given the lack of evidence to support these and other antenatal preparations there are no grounds for midwives to continue routine breast examination in pregnancy for this purpose.
Randomised
controlled trial of breast shells and Hoffman's exercises for inverted
and non-protractile nipples.
Alexander JM, Grant AM, Campbell MJ
BMJ 1992 Apr 18;304(6833):1030-2
CONCLUSIONS--Recommending nipple preparation with breast shells may reduce the chances of successful breast feeding. While there is no clear evidence that the treatments offered are effective antenatal nipple examination should be abandoned.
You can order the Evert-It
Nipple Enhancer (here's
a picture) - item No 441-21, $19.95 in the Accessories section of the
online
La Leche League Store.
Larry's Flat or Inverted
Nipples FAQ - A summary of a devoted dad's research into inverted nipples
- from The Nursing Baby
Breast
Engorgement - Prevention & Treatment
A
Well-Oiled Machine by Jill Stansbury, N.D. - The little-studied and
underappreciated lymph system keeps internal fluids flowing and contributes
mightily to immune function. [Although this isn't directly about
breast engorgement, I think it's a good explanation of the lymph system,
which is largely discounted in Western medicine.]
Oketani Breast Massage - relieves engorgement and improves milk quality
Composition
of milk obtained from unmassaged versus massaged breasts of lactating mothers
FODA Mervat I. (1) ; KAWASHIMA Takaaki (2) ; NAKAMURA Sadako (2) ;
KOBAYASHI Michiko (3) ; OKU Tsuneyuki (2) ;
Background: The Oketani method is a program of breast massage and clinical counseling developed by the midwife Satomi Oketani. The purpose of this study is to examine the effects of the method on the quality of breast milk by determining the chemical composition of the milk before and after massage. Methods: Milk samples were obtained immediately before and after massage from healthy, exclusively breast-feeding Japanese mothers at two different periods of lactation one <3 months the other >3 months after parturition. Lipids, whey protein, casein, lactose, ash, and total solids in milk were measured in milk samples. The gross energy content of milk was estimated. Results: Breast massage significantly increased lipids in the late lactating period but not in the early lactating period. In the early lactating period casein was increased by breast massage but was not significantly affected in the late lactating period. Breast massage caused a significant increase in total solids from the first day to 11 months post partum. The gross energy in the late lactating period was significantly increased by breast massage but not in the early lactating period. Lactose was not significantly changed by breast massage. Conclusions: Breast massage improves the quality of human milk by significantly increasing total solids, lipids, and casein concentration and gross energy. The milk of mothers treated by Oketani breast massage may improve the growth and development of infants.
More information about Oketani massage at:
Treatments
for breast engorgement during lactation.
"AUTHORS' CONCLUSIONS: Cabbage leaves and gel packs were equally effective
in the treatment of engorgement. Since both cabbage extract and placebo
cream were equally effective, the alleviation in symptoms may be brought
about by other factors, such as breast massage. Ultrasound treatment is
equally effective with or without the ultra-wave emitting crystal, therefore
its effectiveness is more likely to be due to the effect of radiant heat
or massage. Pharmacologically, oxytocin was not an effective engorgement
treatment while Danzen and bromelain/trypsin complex significantly improved
the symptoms of engorgement. Initial prevention of breast engorgement should
remain the key priority."
The use of cabbage leaves is a very old treatment, having been used
in England as far back as 25 years ago. Cabbage leaves have also been used
for various other complaints over the years.
The cabbage belongs to the "Brassicacae Family" and contains mustard
oil, magnesium, oxalate and sulphur heterosides. Sulphur in amnio acid
methionine acts as an antibiotic and anti-irritant, which in turn draws
an extra flow of blood to the area. This dilates the capillaries and acts
as a counter irritant, thus relieving the engorgement and inflammation
and allowing milk to flow freely.
Can anyone give me some information on the use of cabbage leaves for
breast engorgement when lactation first gets going? I've heard about it
but know very little.....how and why does it work? Does it matter what
type of cabbage?
In the unit where I work in Victoria, Australia, we use fresh, cold
cabbage leaves frequently for the postnatal women for breast engorgement.
It works fantastically and feel very soothing as well as reduces the supply.
A
comparison of chilled and room temperature cabbage leaves in treating breast
engorgement.
ABSTRACT: This study compared the effectiveness of chilled and room
temperature green cabbage leaves in reducing the discomfort of breast engorgement
in postpartum mothers. Twenty-eight lactating women with breast engorgement
used chilled cabbage leaves on one breast and room-temperature cabbage
leaves on the other for a two-hour period. Pre-treatment pain levels were
compared with post-treatment levels for both conditions. There was no difference
in the post-treatment ratings for the two treatments; mothers reported
significantly less pain with both treatments. We concluded that it is not
necessary to chill cabbage leaves before use.
Cabbage leaves are commonly used to treat engorged breasts. I advise
women to separate two fresh (not cooked) leaves and gently bruise the inner
side with a kitchen utensil i.e. rolling pin. Then one leaf is placed on
each breast for 15- 20 minutes. This can be repeated as often as desired.
There have been a few studies that demonstrate efficacy, but they have
had small numbers.
Other advice for engorgement or mastitis include hot compress before
feeding and cold afterwards.
NOTE - If a woman doesn't respond to efforts to increase her milk supply
as expected, consider the possibility that there may be underlying thyroid
problems. Even if she's already had her thyroid tested in this pregnancy,
consider doing another thyroid test or referring to a physician for evaluation.
I like MegaMam
from Tri-Light Herbs; it's a tasty glycerine formula so my clients will
actually take it! and they like not taking alcohol-based herbs while breastfeeding.
Has anyone tried Go-Lacta™?
It's the leaves of the Malunggay tree (moringa oleifera), an Asian lacatagogue
from Sugarpod Organics.
These suggestions can be found in After the Baby's Birth by Robin Lim
and Earl Mindell's Herb Bible:
Alfalfa - 3 to 6 daily (capsules) or 1 tablsepoon with 8 ouces hot water
brewed into tea daily.
Can buy a variety of prepared commercial products:
Magnetic Mama Lactation Tea with blessed thistle, borage, alfalfa, red
clover, raspberry, fenel, nettles, hops, peppermint from Moonflower
Midwife Formula 6-L: Mega mam with milk thistle, chast tree, fennel,
borage, red raspberry, lemon balm from Spirit
Led
Fennel is a good lactation stimulant and one of the easiest ways to
take it in quantity is the candy coated seeds you get from Indian food
shops. If you've no Asian food shop close (and it has to be the sort frequented
by Asians, rather than the Asian run corner shop) just boil normal fennel
seeds for five minutes, strain and add honey if you want. If she doesn't
like the taste of fennel, other lactation stimulants are fenugreek, celery
and nettle.
Sometimes a mom's milk supply appears not to come in because she's having
so much difficulty relaxing during a feed. This can be the result
of a difficult previous birth or breastfeeding experience, ambivalent feelings
about breastfeeding or body image, or whatever. Obviously, you want
to address the basics - helping her to get completely relaxed, maybe nursing
baby in a warm bath or with her feet in warm water or wrapped in a warm
blanket, aromatherapy, lots of warm loving support, and . . . music, music,
music!
I was delighted with the results we got when a mom started listening
to Renee Smith's music -
it's a wonderful combination of more traditional lullaby styles with more
nurturing lyrics. My personal favorite is her Angels
& Mermaids CD, with her Lullabies
For My Little Angels a very close second. Her Seeds
& Songs To Make 'em Grow is a wonderful collection for "older children",
i.e. toddlers and pre-schoolers, not to mention their parents! I
don't know what it is about this music, but it always makes me so happy!
Cheaper than therapy and lots more fun.
The first case was a women who went to the chiropractor on the referral
of her midwife. She had given birth 10 days earlier to her second
child and unlike her first, she was unable to establish a milk supply for
her second baby. The patient had no other medical issues other than
difficulty in swallowing a glass of water.
An examination determined that she had a subluxation, and specific chiropractic
care was initiated to correct that issue. After her second visit
the patient commented that she found it much easier to swallow. By the
third visit she noticed visible changes in her breast and the production
of milk. This improvement resulted in a positive weight gain for
the infant who was forced to depend of formula until the mothers milk issues
were resolved.
The second patient went to the chiropractor for upper back pain but
was also unable to produce sufficient milk to feed her one month old infant.
Her examination showed no medical history for her problems, however, the
chiropractic portion of her exam showed subluxations. She began a
series of specific chiropractic adjustments for subluxation correction.
By the forth visit the patient was noticing breast enlargement and the
production of milk. She also became pain free from the upper back
pain she was experiencing.
The third case was a women who came into the chiropractor's office with
her daughter six days after birth. She was sent there on the recommendation
of the hospital lactation consultant. As in the previous cases, subluxations
were found and care was initiated to correct them. In this case it
took only 24 hours for the positive results to show, and for this mother
to be able to feed her infant naturally.
Based on their case studies and the volumes of previous research, these
researchers concluded that subluxations and the neurological interference
they cause play a major role in Hypolactation. The researchers suggest,
"Chiropractic evaluation for subluxations would be a key element in the
holistic assessment of the failure to establish milk supply in the postpartum
patient."
Ellen Roos
- Passion Flower
Music - Songs that see and stir, love and forgive, lift, bless and
free! Her first album is Lavender
and Morning Sun.
One thing that bothers me about lactation consulting and "experts" in
nursing is the premise that breastfeeding is always comfortable (ie not
painful). All I ever see is unmedicated babies and mothers.
100% of the time breastfeeding hurts at first. This is with a good
latch and well-educated mothers in advance of the birth. I am of
the mind that it's supposed to hurt and that telling the mother that something
is wrong when it hurts is very undermining. I think the idea of painless,
comfortable first week nursing is a result of most babies being born medicated
out of their little minds. The anaesthetized baby does not suck like
a barracuda.
Just as birth does not progress at home in a watertub the way "they"
say it "should", breastfeeding with a conscious mother and baby is very
different from what I read in books and articles. Naturally born
babies, whose cords are left to pulse, and who find the breast for the
first time in a relaxed, easy way
I'd like to hear from others on your observations. I think we need to
be cautious in telling mothers that something's wrong if breastfeeding
hurts at first. With good positioning (close to chest, tummy to tummy;
ear-shoulder-hip in straight line) the mother/baby pair will sail through
that initial soreness without a big deal and the nipples will toughen.
I've just had a client who was advised that it should NEVER hurt and she
is essentially bottle-feeding now because she was told that the latch was
wrong whenever she expressed discomfort to her lactation consultant.
It all looked fine and normal to me and I was of the mind to just persevere
on through. I'm very upset that her breastfeeding confidence was
so undermined and am now of the mind to ban lactation consultant advice
for the first week. The lactation cons. involved is someone I greatly admire
and I know she has done wonders for women in her area but I think she's
just not used to naturally born barracudas (oops I mean babies!).
I tell my clients that the baby's job is to suck, suck, suck to bring
the milk in and that babies who do this are very smart babies. They
know that by bringing the milk in as quickly as possible, they'll have
milk before they exhaust their birth resources. I reassure them that
once the milk is in, the baby won't need to nurse as strongly or as much,
because the luscious, nutritious milk will just flow into their mouths
with gentle sucking. And it's almost always true.
http:
Snowden H, Renfrew M, Woolridge M.
Cochrane Database Syst Rev. 2001;(2):CD000046.
Cabbage Leaves for Engorgement
The following was written by a Sister Merle Lees who has been researching
this topic.
For Engorgement or Encouraging Letdown
If you're engorged and/or want to encourage letdown, you take a small disposable
diaper ( I use them because I'm lazy and I guess a little selfish, but
you can get a couple from a friend or neighbor if you don't use them) Anyway,
you put about a cup of water in it and microwave it just for a few seconds.
You have to experiment with it and really feel around so it's warm, not
scalding hot. Then you take the diaper and mold it around your breast in
your bra. It fits great, doesn't get you all wet like a washcloth and can
be reheated over and over. I found this to work wonders during those first
days when I was too stressed out to get a good letdown right away, and
when I needed to pump and my baby wasn't able to inspire me, that warm
diaper worked like a charm.
Roberts KL. Reiter M. Schuster D .
Journal of Human Lactation. 11(3):191-4, 1995 Sep.
A randomized, controlled trial was conducted to evaluate the
effect of cabbage leaves on mother' perceptions of breast engorgement and
the influence of this treatment on breastfeeding practices. The subjects,
120 breastfeeding woman 72 hours postpartum, were randomly allocated to
an experimental group who received application of cabbage leaves to their
breasts, or to a control group who received routine care. The experimental
group tended to report less breast engorgement, but this trend was not
statistically significant. At six weeks. woman who received the cabbage
leaf application were more likely to be breastfeeding exclusively, 76 and
58 percent (36/35 vs. 29/50;P=0.09) and their mean duration of exclusive
breastfeeding was longer. (36 vs. 30 days; P=0.04) The greater breastfeeding
success in the experimental group may have been due to some beneficial
effect of the cabbage leaf application, or may have been secondary to reassurance
and improved confidence and self esteem in these mothers
BIRTH 20:2 June 1993
For Increased Milk Supply
Anise - 1 teaspoon powder (crush seeds) in 1 cup boiling water 3 times
daily.
Borage
Dill - 2 teaspoons seeds steeped in 1 cup hpt water for 10-15 minutes.
Strain. Take 1/2 cup 2 to 3 times daily.
Comfrey
Fennel - 10 to 20 drops in water of extract daily. Can purchase
as a tea.
Fenugreek - 2 capsules 3 times a day
Red raspsberry leaf tea
Blessed Thistle - 2 capsules 3 times a day
Caraway - 3 to 4 drops of extract mixed in liquid 3 to 4 times a day.
Can brew herb into tea.
Brewer's yeast - 2 capsules 3 times a day.
Shatavari - an Ayurvedic herb. up to 3 grams of powder in a cup of
warm milk with honey and ghee.
Mother's Milk Tea by Traditional Medicinals
Chiropractic Helps New Mothers Produce Milk
An article in the March 2007 issue of the scientific periodical, the Journal
of Clinical Chiropractic Pediatrics, presents three documented case studies
of chiropractic care helping new mothers who were unable to produce adequate
mother's milk. A reduction in mothers milk, known as "Hypolactation"
can be a serious problem that can create health issues for both the mother
and child.
Initial Breastfeeding Pain
1. don't lose any weight
2. bring the milk in on Day 2
3. cause some initial soreness and trauma to the nipple that is unavoidable
Cracked Nipples
Moist Wound Healing
Nipple
wound care: a new approach to an old problem.
Cable B, Stewart M, Davis J
J Hum Lact 1997 Dec;13(4):313-8
A moist environment is critical for epithelization, the proliferation and migration of epithelial cells across the surface of a wound during healing. Nipple wounds also heal by this process. Using a particular type of wound dressing, a hydrogel sheet wound covering, on a nipple wound offers several advantages. These dressings help maintain a moist environment, decrease the chance of bacterial infection, are easy to use, and provide immediate pain relief.
Moistness-The Secret
of Healing Sore & Cracked Nipples: from the
San Diego Breastfeeding Coalition at breastfeeding.org
Information
about Sheet Hydrogels with a list of manufacturers.
Some people are using ClearSite - a gel dressing. Call Sue Cornell at
1-800-765-8375 ext 2391 to request samples.
There's a lovely vegan product called Breast
Balm from MaternaCare.
I have used this or another type on 2 women now with really good results. Both loved the way it feels, immediate relief from the pain of severely cracked nipples. I have also used it in conjunction with Lansinoh.
I have just cut them to fit around the site of the crack. I do not cover the whole nipple. So far it has worked just to tuck them into the moms bra. With a woman with smaller breasts I would have to play around and see what would work, tape maybe? I try to be sure that we have corrected the problem that has caused the crack and have the mom be fanatical about correct positioning.
So far I have been really happy with the results and have not seen a
problem from the continual moisture. Small sample, I know, but I haven't
heard any bad reports from lactnet either.
Geranium leaves for intractable cracked nipples. Lansinoh
is also very good.
Lansinoh Samples
Call (in the USA) 1-800-292-4794 and Lansinoh Laboratories will send you
free samples with an informational brochure that includes LLLI's endorsement,
history and phone number. They will send you a supply monthly.
Breast-Feeding Cuts Infant Infection Risk
Seeking
Relief - Excellent page from LLL site about diagnosis and simple and
more complicated treatments for nipple vasospasm
Raynaud's
Phenomenon of the Nipple May Cause Painful Breastfeeding by Laurie
Barclay, MD [Medscape]
This article on Using
Gentian Violet has some helpful points about diagnosing thrush vs.
nipple vasospasm. In particular, they write, "The pain caused by
a Candidal infection is generally different from the pain caused by poor
positioning and/or ineffective suckling. The pain caused by a Candidal
infection . . . Frequently lasts throughout the feeding, and occasionally
continues after the feeding has ended. This is in contrast to the pain
due to other causes that usually hurts most when the baby latches on, and
gradually improves as the baby sucks."
If you're trying to find a doctor who will prescribe Nifedi
