Intro and Question

[Guest guest]

Hi Ann,

Good to see you on this list also!! And so sorry to hear of your mother's passing. My heart feels for you.

Kathy Parkes, RN, IBCLC, RLC

The Lactation Connection Inc.

San , TX

[Guest guest]

Just an idea - could they put Human milk fortifier in the breast milk he gets to inc the proteins?

>From: " Ann "

>Reply-To: >To:

>Subject: Intro and question >Date: Sat, 11 Jan 2003 01:15:19 -0500 > > After being a LLLLeader for 22 years, I decided it was time for me to sit > for the LC exam, and I passed it this summer!! I continue with my > LLLeadership, and now am exploring avenues to use the additional initials > behind my name. I thoroughly enjoy reading the case studies on this list. > I have been just reading lately as my outside activities have been >curtailed > due to the illness and death of my mother (last month). So this has been a > challenging time for me. > > Today I got word that one of my LLL babies got burned yesterday, almost 20 >% > of his body, and the mom is being restricted on the amount she can nurse >him > because they want him to eat more protein than they feel her breastmilk can > supply. Anyone have any ideas about burn treatment of a 15 month old > nursling and its relationship to breastfeeding? I have only talked with >the > dad because mom and baby are in the PICU, and I just found out, and haven't > been able to get to the hospital. Dad says that approximately 15 to 20 % >of > babies total intake, prior to incident (which was on Thursday), was from > non-breastmilk sources. > >The mom has asked to see an LC, but one hasn't shown up yet. . . and it is >now the weekend!! Aargh! > >Have any of you had experience with a burned nursling and his/her treatment? >I know they want the baby to have more proteins, but what is the best way to >make that happen? How much protein is in breastmilk? So far he only has an >IV in the groin (because the wrap for the burns on the thorax cover the >whole chest, I think). Anyway, I'm planning to see them tomorrow, and would >welcome any input. > >Thank you, > Ann >Lansing, Michigan > MSN 8 helps eliminate e-mail viruses. Get 2 months FREE*.

[Guest guest]

Maybe you could search for the research on bathing burn wounds with breast milk - it decreases swelling and bacteria counts.

>From: " Ann "

>Reply-To: >To:

>Subject: Intro and question >Date: Sat, 11 Jan 2003 01:15:19 -0500 > > After being a LLLLeader for 22 years, I decided it was time for me to sit > for the LC exam, and I passed it this summer!! I continue with my > LLLeadership, and now am exploring avenues to use the additional initials > behind my name. I thoroughly enjoy reading the case studies on this list. > I have been just reading lately as my outside activities have been >curtailed > due to the illness and death of my mother (last month). So this has been a > challenging time for me. > > Today I got word that one of my LLL babies got burned yesterday, almost 20 >% > of his body, and the mom is being restricted on the amount she can nurse >him > because they want him to eat more protein than they feel her breastmilk can > supply. Anyone have any ideas about burn treatment of a 15 month old > nursling and its relationship to breastfeeding? I have only talked with >the > dad because mom and baby are in the PICU, and I just found out, and haven't > been able to get to the hospital. Dad says that approximately 15 to 20 % >of > babies total intake, prior to incident (which was on Thursday), was from > non-breastmilk sources. > >The mom has asked to see an LC, but one hasn't shown up yet. . . and it is >now the weekend!! Aargh! > >Have any of you had experience with a burned nursling and his/her treatment? >I know they want the baby to have more proteins, but what is the best way to >make that happen? How much protein is in breastmilk? So far he only has an >IV in the groin (because the wrap for the burns on the thorax cover the >whole chest, I think). Anyway, I'm planning to see them tomorrow, and would >welcome any input. > >Thank you, > Ann >Lansing, Michigan > get 2 months FREE*

[Guest guest]

Hello All,

I want to introduce myself and say I’m thrilled

to be a part of this list.  I look

forward to learning and sharing.  I’m

a new IBCLC and a LLL Leader of almost 8 years. I have a husband of 21 years

and 4 sons ages 14, 12, 9, and 5(still loves his “leche”).

They keep me very busy so I’m taking baby steps in setting up a private

practice.  Nonetheless, I’ve

already gone on several home visits which brings me to

my questions for you all. 

What do you do when a client cancels her appointment

at the last minute?  I was already out of

the house.  My cell was charging and did

not have it on.  She left late messages

both at home and cell.  I did not learn

of this till I arrived at her home.  

I had already seen her Friday night.  She called Sunday afternoon urgently requesting

a follow up.  Today afternoon was the

soonest I could get to her.  As she

informed me upon opening her door, her reason for canceling was (drumroll) she decided to quit breastfeeding because baby

was too fussy and she wasn’t enjoying breastfeeding anymore. She asked me

to come in anyway since it was cold outside. I asked,

when did you make this decision?  “Last

night.” I had my scale with me so I offered to weight the baby anyway (at

the hospital they told her she should supplement because her baby’s

weight loss: from 8lbs to 7lb 9oz – a whopping (not) 7 ounces or 5.5%) 

Other isssues affecting

this mother and baby were epidural with vacuum extraction (baby had a large

bulge on upper right side of head); lack of support in hospital and misinformation

of how to latch (lots of nurses head-ramming baby to breast), telling her

nipples were inverted (actually an eighth of an inch shy of flat), they gave

her wrong size nipple shield; she was Strep

b-positive and baby had slightly elevated white blood cell count. She did not

get to put baby to breast for many hours and then, very irregularly. Not the

kind of start a young new moms who’s a bit naïve and uninformed needs to

get going.

After the first visit baby latched well with the

nipple shield.  We heard audible rhythmic

swallowing and after a little while, pumped 3 ounces in 15 minutes. Her milk

was obviously coming in quite well. We worked on positions to keep baby

comfortable, seemed very fussy lying on right side probably due to vaccum. I

left them nursing and explained that the next few days would be hard work.  She expressed how grateful she was and said something

like, “My body was aching to do this.”  I’m thinking, wow.   So how

did she go from that feeling to quitting? 

 Last night, middle of the night,

she was breastfeeding with nipple shield. 

Baby was fussy after the feeding so she followed up with 1.5 ounce of

pumped milk.  After a little while baby began

to fuss again so grandma then gave 2 ounces of formula.   Upon

which she concluded that her baby was too hungry to be breastfed!?!@$#%^%  I’m thinking,

that’s it? You’re giving up based on one bad fussy feed. I wanted

to engage her in a bit more discussion. 

I checked weight.  Baby was

already up to 8lbs 1.3 oz regaining birth weight and more by day 6. I pointed

out that this had happened mostly on her milk and that most peds

don’t expect babies to do this till 2-3 weeks postpartum.  So breastfeeding was actually going better

than “we” thought.  I was

hoping for a change of heart at these words but it did not come.  

So, I moved on and explained the dangers of sudden

weaning and binding which was her approach of choice (grandma’s suggestion),

explained the alternatives, and wished her luck.  Of course, as I drove home I came up with a

few lines I wish I’d tried and thought live and learn.

I felt this young new mom’s decision was made

under pressure from family, lack of sleep and lack of knowledge.  If any of you have encountered anything like

this would you share your thoughts, suggestions, one

liners?

Thanks and sorry, I did not mean for this post to be

so long.

Carmen

Carmen , BA, LLLL, IBCLC

[Guest guest]

This mother has so many risk factors (frightening birth, emergency hysterectomy, chronic maternal health problems, ....) for a traumatic stress reaction and depression that Reglan seems a very risky galactogogue, given that depression can be a side effect. She has more than enough to cope with without the potential for depressive side effects due to a medication for which alternatives exist.

What is the chlorpromazine being prescribed for? Hale 2006 says "avoid if possible." What are alternative medications?

And, what support and services is she receiving for having gone through a difficult, if not traumatic, birth experience? Medication should never be the sole treatment offered to a mother coping with a traumatic stress reaction and/or depression.

-- Good Mojab, MS clinical psychology, IBCLC, RLC, CATSM LifeCircle Counseling and Consulting, LLC Website: www.lifecirclecc.com Phone: Email: admin@... Ammawell Website: http://home.comcast.net/~ammawell Announcement only email list: ammawell-subscribe

-------------- Original message -------------- Hi everyoneI have been lurking for a few weeks now and the time has come to post! Im Nicola O'Byrne , IBCLC ( 2005)in private practice in Dublin Irelandand I have sooo many questions for you all. My background is neonataland paediatric nursing and voluntary Bf counselling for the past 8years . I started in pp last November and have good and bad days butgenerally am very pleased and love what i do. Its tough at timesbecause I am the only full time IBCLC in PP here and the supportnetwork could be better. I am married with 3 children aged 9,5 and 2 . ( 2 boys and a girl) . So my question... I have been working with a mum for the past 3 monthswho had a pretty horrific time, labour 30 weeks, PPH , ? sheehans ,emergency hysterectomy, delayed lactog

enesis 2, and now only producing200 mls daily at 15 weeks post partum. We have tried domperidone,fenugreek, blessed thisle , goats rue, oatmeal. Expressing usingsymphony , 8 times daily, putting baby to breast but he only sucklesfor 5 minutes or so then gets tired or cries , breast compression,oxytocin nasal spray , used SNS for 3 weeks but they couldn't manageit and gave up. Basically Mum has multiple Sclerosis and is weak andtired. She is absolutely wonderful and really wants him to havebreastmilk. we had donor milk from our bank up to 2 weeks ago but thebank now says there are other babies who need it more.The baby is now on bottles of a mixture of EBM and ABM. I know thatits not ideal , bottles but the volumes are so large now its not anoption to do it any other way. I saw him last week and he actually hasa good latch but only swallows every 5/6 sucks. He is doing well buthis mum is really upset , its all hitti

ng her now. She is on Reglanfor a 1 week trial( stopped Domperidone) but so far it has reduced thesupply slightly. She wants to try Chlorpromazine . I dont. I justthink its too risky but then I have never seen it used. Has anyonehere ? Are we gone as far as we can go? Is there any experts ( apart from you lot!) who might look at hercase? We emailed dr newman but he doesnt have the time to go into itfully. I really would appreciate any help you can give me . Phew! From a beautiful sunny day in DublinNicola

[Guest guest]

Hi again.

This is fabulous and right on the ball. Thanks Anne, Margaret and

. I am going to look for a counsellor that deals with birth

trauma. Anne ,I read that article from JHL and it is indeed very good.

I think my role is to stay in touch and provide emotional support

until she feels ready to accept things and move on. One thing though..

this mum is getting married next week and has invited me and my family

to the

reception ( only about 2 hours drinks/canapies) . Im very unsure about

this and if its the right thing to go. Its so nice of them and I feel

I would be letting her down as she doesnt know many people in Ireland

and in a way i think i will always be in contact with her.

Opinions please to go or not?

Nicola

See I told you I had loads of questions!!

[Guest guest]

I think has some good points, but I do think our relationship with a client as an IBCLC is different than a relationship as a counselor. I can't define it exactly, but perhaps it is the mother-to-mother aspect of breastfeeding consultation.

For example, I would be the lactation consultant for any of my friends or my friends' children (and heaven knows I have been) -- but I wouldn't be their clinical counselor.

This is what Tenet 16 actually says:

16. Refuse any gift, favor, or hospitality from patients or clients currently in her/his care which might be interpreted as seeking to exert influence to obtain preferential consideration.

Emphasis mine. I don't think being invited to a wedding reception for a client with whom you have developed a close relationship through your professional association would be interpreted as that person seeking obtain preferential consideration -- and that statement has to be interpreted for me anyway, as I haven't a clue as to what it means.

So -- in my opinion, if you want to go -- do so. If you don't, don't go. 's opinion is that you shouldn't.

There you have it. Two different opinions. And you need to do what you, in your professional judgement and in your heart of hearts is right.

(\__/)(='.'=)(")_(") JanLactation Education Consultants My Mother of the Bride Blog Torrey's Blog

[Guest guest]

If you can't find one in your area, does phone consults.  I have had good feedback from moms who have consulted with her :-)LynnetteHi again. This is fabulous and right on the ball. Thanks Anne, Margaret and. I am going to look for a counsellor that deals with birthtrauma. Anne ,I read that article from JHL and it is indeed very good.I think my role is to stay in touch and provide emotional supportuntil she feels ready to accept things and move on. One thing though..this mum is getting married next week and has invited me and my familyto thereception ( only about 2 hours drinks/canapies) . Im very unsure aboutthis and if its the right thing to go. Its so nice of them and I feelI would be letting her down as she doesnt know many people in Irelandand in a way i think i will always be in contact with her. Opinions please to go or not? Nicola See I told you I had loads of questions!!

[Guest guest]

Thank you for your kind words, Lynette!

-- Good Mojab, MS clinical psychology, IBCLC, RLC, CATSM LifeCircle Counseling and Consulting, LLC Website: www.lifecirclecc.com Phone: Email: admin@... Ammawell Website: http://home.comcast.net/~ammawell Announcement only email list: ammawell-subscribe

-------------- Original message -------------- From: "Lynnette Hafken, IBCLC" lhafken@...

If you can't find one in your area, does phone consults. I have had good feedback from moms who have consulted with her :-)