New IBCLCs!!

Congratulations to the new International Board Certified Lactation Consultants!

Nipple Shields, Friend or Foe

I have two upcoming blogs on Nipple Shields.  One will be at my own site at www.babylatch.com  and the other at www.scienceandsensibility.org .  Before I post those I would like to get some feedback from you, as a practitioner or as a mom, on your experience with shields.

In our clinic at the International Breastfeeding Centre, we are now seeing babies on nipple shields in record numbers--and mothers want them off!  I use to see 1 or 2 a week, now we see a few every single day--some days 5 or 6.  And in the past, many of the babes I would see would have been started on a shield after a week or two of age at the earliest, with the rare one having been started sooner.  Now, we are seeing them routinely given when the baby is days or even hours old.  Some mothers are handed them in the delivery room, before baby has even had a chance to know where the breast is!!

The number one reason mothers are given a shield, or it is suggested to them to get one, is for the baby who is refusing to latch.  In the short term, this sometimes works--but what are the long term ramifications?  Some mothers are given them to prevent or treat sore nipples.  I often see this makes things worse, but once in a while a mother says it helped--but then, again, long term, regardless of why she was given the shield, she ends up at our clinic with a host of other issues: baby pulling at the breast due to slow flow, drop in milk supply, baby addicted to the shield and can't get off, etc, etc.  But there must be some mothers out there for whom the shield saved her breastfeeding and the baby did not get addicted—otherwise, why would practitioners use them so routinely?  They, the practitioners, must be convinced the shields do more good than harm, right?  I don’t know if that is correct or not, but I would love to hear from those who do use them.

So, my question to you is, do you see them helping short term and long term?  If they were helpful, for how long, for what issue, and how long until you got baby off the shield?  If they were not helpful, or only for a short bit, were there other issues that arose as a result of using the shield, and, if so, what were they?   Were you able to get baby off the shield in the end?

Thanks for the feedback.

E

Edith Kernerman, IBCLC
www.babylatch.com
www.nbci.ca 

The Who Code and IBCLCs

I am dismayed by the change in wording in the IBLCE professional code of conduct for IBCLCs.  Previously the code of conduct stated that IBCLCs must abide by the provisions of the WHO International Code on the Marketing of Breastmilk Substitutes.  Now, the wording has been changed to state that IBCLCs should endeavor to abide by the Code.  This is an incredible watering down of the statement.

Why on earth should IBLCE change this wording?  The WHO Code has been an extremely useful tool to help prevent the abuses of the formula, bottle and teat manufacturers in marketing their products.  It gave health professionals pressured by formula company reps (and their methods are very effective) an easy out, so that the health professional could say, for example “I am sorry but I cannot give out your product to the pregnant women or new mothers in our facility because the Code does not allow it”.  There was no need to argue with the formula company rep about “women who give supplements breastfeed longer” (yes, the formula companies actually used and maybe still use that line).  It’s not allowed!

If this change in wording is not revoked, IBLCE will lose all credibility with everyone but the formula company manufacturers.  Is that what IBLCE wants?

- Dr. Jack Newman

Maternal IV fluids linked to newborns' weight loss

Public release date: 14-Aug-2011[ Print | E-mail | Share ] [ Close Window ]

Contact: Dr. Hilary Glover
hilary.glover@biomedcentral.com
A newborn baby's weight loss is often used to determine how well a baby is breastfeeding, and concern about a baby which loses too much weight may result in supplementing breastfeeding with formula. However, many women receive IV fluids during labor, and new research published in BMC's open access journal International Breastfeeding Journal shows that some of a newborn's initial weight loss may be due to the infant regulating its hydration and not related to a lack of breast milk.

A group of Canadian researchers looked at relationships among the IV fluids a mother received during labor (or prior to her caesarean section), neonatal output (measured by diaper weight), and newborn weight loss. They found that during the first 24 hours following birth there was a positive association both between the IV fluids given to mothers before birth and neonatal output, and between the neonatal output and newborn weight loss. At 60 hours post birth, the time of the average lowest weight, there was a positive relationship between maternal IV fluids and newborn weight loss...

"Nurses, midwives, lactation consultants, and doctors have long wondered why some babies lose substantially more weight than others even though all babies get small amounts to eat in the beginning," said principal investigator Prof Joy Noel-Weiss from the School of Nursing at the University of Ottawa's Faculty of Health Sciences. "It appears neonates exposed to increased fluids before birth might be born overhydrated, requiring the baby to regulate his or her fluid levels during the first 24 hours after birth."

Prof Noel-Weiss added, "We should reconsider the practice of using birth weight as the baseline when calculating newborn weight loss in the first few days following birth. For mothers and their breastfed babies, accurate assessment of weight loss is important. Although more research is needed, based on our findings, we would recommend using weight measured at 24 hours post birth as a baseline."
Alongside this article, the researchers have provided a standardized method for clinicians to collect and analyze data about newborn weight loss in their own maternity site, in the hope that this protocol will help them to make informed decisions when assessing newborn weight changes.

###

Notes to Editors1. An observational study of associations among maternal fluids during parturition, neonatal output, and breastfed newborn weight loss
Joy Noel-Weiss, A Kirsten Woodend, Wendy E. Peterson, William Gibb and Dianne L Groll
International Breastfeeding Journal (in press)
2. Iatrogenic newborn weight loss: knowledge translation using a study protocol for your maternity setting
Joy Noel-Weiss, A Kirsten Woodend and Dianne L Groll
International Breastfeeding Journal (in press)

Here is the link to the full article http://www.eurekalert.org/pub_releases/2011-08/bc-mif081211.php

Congratulations Dr. Noel-Weiss on a fantastic and much needed study.

Newsletter!

Hey everyone!

Our Newsletter is being sent out for the first time!!

If you have not signed up for the newsletter yet you can sign up at http://breastfeedinginc.ca/ and click the link towards the bottom of the page.

Some of the features on the newsletter include the Bonapace Program we are offering in Toronto, Edith Kernerman's new Pain Algorithm and Dr. Jack Newman's Spanish book!

Happy breastfeeding!

Article on Milk Sharing

Our very own Edith Kernerman has been interviewed for this article on milk sharing!


Click the link to read about the latest news in breastfeeding!

http://montreal.openfile.ca/montreal/file/2011/07/sharing-breastmilk-montreal-weird-or-wonderful

World Breastfeeding Week!

World Breastfeeding Week is a yearly event started in 1991 by the World Alliance for Breastfeeding Action (WABA). Over 170 countries participate worldwide in this week commemorating the first meeting of WABA.  It is celebrated worldwide from August 1-7th.

This year, World Breastfeeding Week is taking a “3D” approach to breastfeeding by adding a necessary factor - communication!  WABA is saying that the act of breastfeeding and the support systems around mothers are promoted and accessed better by having better communications, especially during this day and age!

WABA seeks to encourage communication across borders of age, ethnicity, gender, and every other kind of border you can think of. Only in this way will we, as WABA says, be able to provide the best help to mothers and babies.

WABA’s goals for the World Breastfeeding Week are to:

“-Encourage communities and health facilities to use new media technology to reach larger numbers of people with breastfeeding information and alert them about the conflicts of interest that may arise when entities which profit from selling or distributing products under the scope of the International Code of Marketing of Breastmilk Substitutes (Code) promote breastfeeding.
-Broaden the scope of breastfeeding advocacy to involve traditionally less interested parties (i.e. youth, men, family planning advocates).
-Develop and scale-up communication skills education in breastfeeding and health trainings and look for active participation from young people.
-Through networking, create and increase communication channels between different sectors so breastfeeding information and feedback can be accessed and enhanced.
-Encourage mentorship by breastfeeding experts for new advocates, and by experienced communicators for those newly entering the communication era, regardless of their age.
-Creatively explore, support, recognise, and implement innovative communications
approaches and provide a space for people to develop their ideas.”

For more information about WABA and the World Breastfeeding Week, check out http://worldbreastfeedingweek.org/ and http://waba.org.my/.

Happy Breastfeeding!