RE: Re: new AAP recomendation regarding iron supplementation

[Guest guest]

,

I loved your commentary -- so very well done.

However, I will point out that according to your statement below, every baby in the US of A that is born in a hospital is at risk for needing additional iron BEFORE six months.

So -- what we need to be doing is really making a big push to stop premature cord clamping. Because every baby has the cord cut and clamped within seconds of birth -- unless the baby is fortunate enough to be born at home, or perhaps in a true alternative birth center with a midwife that understands these sorts of issues.

Jan Barger

Prematurity, premature cord clamping, low birth weight are all risk factors for needing additional iron BEFORE six months.

[Guest guest]

Regarding early cord clamping, is this not an issue when parents have the cord blood saved? It seems to me that parents should be informed of early cord clamping and risk of iron deficiency and whose responsibility is this? I, for one, am so tired of all the interference with the norm for the sake of technology. Poor parents today have so many decisions to make, and so much conflicting information. I feel for them.

Barbara Latterner

Brewster, NY

[Guest guest]

cutest skeleton I've ever seen address

please?

Lou

Moramarco IBCLC

Birth,

Breastfeeding & Beyond

International

Board Certified Lactation Consultant

Bradley

Childbirth Educator

Certified

Birth Doula

(732)

239-7771 marylou22@...

From:

[mailto: ] On Behalf Of popikins

Sent: Saturday, December 04, 2010

11:32 AM

To:

Subject: Re: new AAP

recomendation regarding iron supplementation

In cases like this I speak from my own resources, and

the parents get to decide which approach they choose to follow (as it should

be!). I'm not reluctant to interject information as I know it, I think they key

here is we better 'know' it. Meaning for me I'm prepared to have a MD or CNM

consult with me about the recommendations I make and am prepared to provide the

research/data to support it. Thankfully from what I can tell I work in a

collaborative community, I work with a lot of providers and see a lot of

clients and I have yet to experience what I would consider a 'conflict' with

any HCP about my recommendations, although I have had my share of what I would

consider collegial, lengthy discussions about issues where the HCP was grossly

misinformed. Probably the most lengthy discussion I've had took about half an

hour for us to thoroughly exhaust review of one another's resources regarding a

chest scan and the HCP's direction to pump and discard, which wasn't necessary

and the MD eventually withdrew her instructions. I don't mean being challenged

(for lack of a better word) about these types of things, I think in most cases

it comes from a place of regard for the safety of mom and baby so I am happy to

dialogue about it.

So you might respond to " wackadoo " recommendations with something

like, " Hmmmm, that's interesting. I'm not familiar with that

recommendation. My training and resources have concluded..... " I've given

patients copies of various resources, printed LactMed to share with them and

they can share it with their provider to discuss as they desire etc.

I think the key lies in our ability to be diplomatic with our communication

style. I think we are obligated to correct misinformation when it appears

before us.

>

>

> Hi Everyone,

>

> Things have been really stressful for me at home so I am only now getting

a chance to say... Yay me! I passed the exam... with a very nice score I will

add to brag just a bit. ) But that is an aside. I actually have a concern for

which I would like opinions.

>

> Right after I got my results the strangest thing happened. I was in a

store shopping as I normally do and was passing by a woman in the juice aisle.

As I was passing, she loudly said... " Please can someone help me " . I

stopped and said " of course what is it " She then proceeded to tell me

that she was trying to pick out a juice for her baby... not sure if she should

get the expensive small 4 pack with the baby on the front or a regular bottle

of prune juice. I paused thinking how to respond as I don't recommend juice for

babies at all... but that really wasn't her question. I think she saw the

confusion on my face or was just ready to pore out her heart... but she

proceeded to tell me how she couldn't believe she was in this situation. That

her perfectly healthy no problems up till now 4 month old baby went to see the

pediatrician for a check-op a few days ago and was told she needed iron

supplements. She had been giving them for 3-4 days and her baby had changed

from happy and healthy to crying, constipated and miserable and she didn't know

what to do. She was trying to find a juice to relieve the constipation. Thanks

to you wonderful ladies and my LLL buddies, I knew about this new

recommendation and could talk to her about it knowledgably. She was especially

confused because she didn't understand why her baby needed it as she thought

breastfed babies had everything they needed for 6 months. She also said she

asked how they could know her baby was anemic without a test to determine

this... esp. since her baby didn't show any classic signs of anemia like

fingernail blanching, paleness or dry skin... this was clearly a savvy mom

(IMO). She was told by her pediatrician that all breastfed babies need the iron

because they didn't get any in breastmilk.

>

> She was relieved to find out (by me) that the research this was based on

was extremely limited and at the conclusion of our discussion put the juices

back and went home to breastfeed her baby. She left h

[Guest guest]

I'm sorry, I just saw that I sent an e-mail to this group

about a cute skeleton that probably made no sense. It was a response to an

adjacent e-mail. Fat fingers strikes again on my droid.

Lou

Moramarco IBCLC

Birth,

Breastfeeding & Beyond

International

Board Certified Lactation Consultant

Bradley

Childbirth Educator

Certified

Birth Doula

(732)

239-7771 marylou22@...

[Guest guest]

Barbara and all,

In my experience in the labor room there is still PLENTY of

blood for banking after the cord is left to stop pulsing. A pocket here a

pocket there. The syringes and bags the banking companies send out to

fill are huge but apparently they don't need to be filled to the fullest.

I have seen where only a small portion of the required samples are collected

and the couples have let me know the banking companies confirmed a successful

draw.

Even if the parents interview a potential pediatrician

before the birth of their baby, unless they ask, they wouldn't necessarily know

about the couples decision to bank. And that is only if the parents do

interviews in advance, some don't see their pediatricians until after the baby

is born. In my opinion it should be the OB/care giver who informs the

parents of the potential iron deficiencies risk associated with early cord

clamping. They are probably the only ones who know about the decision to

bank the cord blood. Do you think they are reading the AAP

Journals?

Or maybe it should be included in the reading materials in

the banking kits that are sent out in advance to the couples themselves.

Lou

Moramarco IBCLC

Birth,

Breastfeeding & Beyond

International

Board Certified Lactation Consultant

Bradley

Childbirth Educator

Certified

Birth Doula

(732)

239-7771 marylou22@...