RE: [ozmidwifery] Re: breastfeeding
Well said Lieve!! Midwives and child health nurses must learn so much more about breastfeeding so that when the mother accepts this is how she will feed her baby, there really and truly isn't anything else out there that could have given her a different outcome. Denise On 20/05/2005 4:04:59 PM, ozmidwifery@acegraphics.com.au wrote: It always wonders me that every woman get's so personaly involved with a discussion around breastfeeding. For me it proves that the experience women have with feeding their children is very important and that the feelings around it last a lifetime. When breastfeeding failes it is very important that the mother has the feeling and knows that she was involved in the proces, that she was supported in every (informed) decision she makes. It is the same with c-section. When the mother really knows it is her way of birthing or feeding and she has made the neccessairy decisions, helped by really supportive midwifes and doctors also afterwards, it doesn't feel like a failure, just as a fact of life that not always goes as we want it to go. Lieve *** Denise Fisher Health e-Learning http://www.health-e-learning.com [EMAIL PROTECTED] -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] RE: breastfeeding
I'm really disappointed to see in a supposedly professional discussion of a professional issue, ie breastfeeding, that name calling is resorted to very quickly. The terms used by two posters, who, of course, were only reporting what 'other' people say, were crude and vulgar to say the least. And if we have any colleagues of the Jewish faith in our midst they should be rightfully offended by referring to people who support mothers to feed their babies naturally with the same term as describes the group who exterminated millions of their people during World War II. Please be aware of what you are saying, and what you are perpetrating by telling the world that 'someone else' said. Denise *** Denise Fisher Health e-Learning http://www.health-e-learning.com [EMAIL PROTECTED] -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Re: breastfeeding
The trying times that Jo experienced breastfeeding will only have been
'worth it' to we professionals if we can learn from it, and other women's
experiences. (Jo, I'm guessing you felt it was worth it for you and your
child regardless - taking nothing away from what you went through).
It's undeniable that artificial feeding is inferior nutrition for infants.
So, rather than fighting for a mother's right to not have to put up with
pain, cracks, mastitis, cellulitis, etc, etc, etc, let's direct all our
energies into finding causes and solutions for these problems. And to
educating our colleagues about what we have already learnt.
Oh well ... that's what makes sense to me. X;{
Denise
***
Denise Fisher
Health e-Learning
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Re: [ozmidwifery] FW: Breastfeeding
Hi Carina You've brought up some points that are good food for thought. It was a tragedy the day that milk banks were closed in Australia due to the scare with HIV, despite pasteurisation easily killing HIV (I wonder why sperm banks weren't also closed??). I note that a new bank is opening in WA and perhaps one in Melbourne. I wish them success. The incidence of physiological inability to breastfeed is somewhere in the order of 1 - 2 per 100 women. I don't believe with an incidence at this level that it warrants we guard everything we say to every woman. And then there's that really fascinating topic of 'guilt'. Can you induce guilt in someone? - maybe, if they really are guilty. However I don't feel guilty about something I have no control over. For example if I had no uterus I wouldn't feel guilty that I'm not adding to Australia's population, no matter how much Mr Howard exhorts me to. If I had no breasts or my breasts were not functional I would not feel guilty that I'm not breastfeeding regardless of how many people told me it was best. My opinion is that some health professionals don't know how to support women to breastfeed adequately and in covering their own feelings of guilt about this they 'pretend' that it's the mother they are trying not to make feel guilty. To give you lots of different opinions on guilt and breastfeeding do a google search using those terms. Have fun Denise At 03:23 PM 18/05/2005 +0930, you wrote: Some food for thought, What about the women who simply cannot breastfeed and cannot produce enough milk The wet nurse is still in existence in many tribal cultures where formulary has no influence. Its very easy to be passionate about something and sing its praises when you have experienced success, but what about those women who dont succeed despite months of trying and perseverance. I, like all many midwives of course believe that breast is best and should be promoted as optimum nutrition for a baby but sometimes I believe that in trying to get this message across we need to be careful not to make other women lose their confidence ands fall into the motherhood guilt trap. Carina *** Denise Fisher, MMP, BN, IBCLC Health e-Learning http://www.health-e-learning.com [EMAIL PROTECTED]
Re: [ozmidwifery] FW: Breastfeeding
never a single breastfeeding problem. In between were the women with minor problems through to those with truly dreadful stories and very few of them seemed to be getting great advice. My dear friend had her second child two weeks ago and the visiting midwife (from the RPA) tried to tell her to stop demand feeding, that she was feeding way to much, should feed only every 3-4 hours and that she must sleep more or she was in danger of hurting herself and hurting her baby (she is an experienced breastfeeder with great family support and knew this advice was laugable). In the end my friend agreed with everything she said just t! o get her out the door and make sure she never came back. So now she is trying to figure out on her own how to deal with a sever over supply problem and a late developing attachment problem Given she has over 2 years breastfeeding experience I know that she will sort it out but she should not have to do it on her own. I am sure that most australian women give up due to poor through to appalling advice from health professionals, possibly combined with lack of support from their families/partners not due to a physical inability to feed. sorry for rambling, my fertility treatment has gone seriously wrong in the last fortnight so my hormones are whacked and interfering with my concentration but I really wanted to say something... cheers Jo *** Denise Fisher Health e-Learning http://www.health-e-learning.com [EMAIL PROTECTED]
[ozmidwifery] Justine and TV last night
Well done Justine! What I particularly liked is that they gave you the last word! and those words were well chosen. Denise *** Denise Fisher Health e-Learning http://www.health-e-learning.com [EMAIL PROTECTED] -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] NZ Herald Content Link sent by Barb
Yes. All NICU's should have moved to liquid formula by now. The only exceptions being the specialised formulas that aren't available in liquid form. Actually the advice is for all infants less than a month old. So even well full term babies who are formula fed should be having a sterile liquid formula until they are a month old. Read this article too from the UK and the European recommendations. http://tinyurl.com/4ua2n I'm a bit disappointed to see the staff blaming the Ministry for Health in the article you linked us to. I would have thought that it would be the practitioner's responsibility to keep up to date with what research and changes were going on in the world - and the enterobacter sakazakii contamination was well broadcast at the time it occurred in each country. Denise At 09:45 PM 6/04/2005 +1200, you wrote: Dies this mean only bottled formulas are used in NICU's? --- http://www.nzherald.co.nz/index.cfm?objectID=10118987msg=emaillink --- *** Denise Fisher Health e-Learning http://www.health-e-learning.com [EMAIL PROTECTED]
[ozmidwifery] cord care
Thought you may be interested in this review of the literature on cord care. http://www.medscape.com/viewarticle/497030?src=mp Cheers Denise *** Denise Fisher Health e-Learning http://www.health-e-learning.com [EMAIL PROTECTED] -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] implanon and breastfeeding
Hi Jackie All the progesterone-only contraceptives are safe to use while breastfeeding; ie the breastfeeding baby will apparently not be adversely affected. However, some mothers are more sensitive to progesterone than others, and these mothers may find they have a small to marked decrease in milk supply. All of the progesterone-only contraceptives, to the best of my knowledge, categorically say that they should not be started before 6 weeks postpartum. I know that many doctors will start them earlier, but this does put breastmilk supply at greater risk of being affected. I personally think that starting breastfeeding mothers on a contraceptive so early (ie before leaving hospital most of the time) is very paternalistic .. ie. She can't be trusted to return at 6 weeks to get her contraception sorted out. I'll have to fix her up now! And the fall in progesterone that happens when the placenta is delivered is what is essential for lactogenesis II to occur. With early discharge and the big imperative to do everything before she leaves I wonder how often breastfeeding is actually being adversely affected. Implanon probably isn't too bad because it can be removed fairly simply if this mother does find her supply is diminished. Injectables such as Depo provera are a big problem though, because there's no going back. The best advice is to start on the mini-pill. If there is no diminished supply from that after a couple of months, then go to the slow-release contraceptives. With exclusive breastfeeding and no return of menses the risk of getting pregnant while using no other form of contraception during the first 6 months post partum is exactly the same as it is when using the progesterone-only pill. BTW is implanon now approved in Australia for breastfeeding mothers?? At 02:09 AM 22/03/2005 +1030, you wrote: Does anyone have any information about whether the contraceptive Implanon has any effect on breastfeeding? Baby is 4 weeks old and feeding well. Jackie *** Denise Fisher Health e-Learning http://www.health-e-learning.com [EMAIL PROTECTED]
Re: [ozmidwifery] implanon and breastfeeding
Yes, Kim it is the one that gets inserted into the arm. Here's a link to some info about it. http://www.fpahealth.org.au/sex-matters/factsheets/28.html Cheers Denise At 04:20 PM 22/03/2005 +1100, you wrote: Just out of curiosity Is implanon the one you get inserted in your arm? What is it's recommended life? Has this replaced the Mireana (IUD)? Kiwi Kim *** Denise Fisher Health e-Learning http://www.health-e-learning.com [EMAIL PROTECTED]
Re: [ozmidwifery] sharing 'different' info
Hmmm not really sure why you feel you would be crucified Kim. This used to be a pretty safe place to be. :-) Good midwifery care doesn't stop with the birth of the baby. We follow on with that great care, ie excellent, supportive, knowledgeable guidance, if needed, to breastfeed. Breastfeeding and artificially feeding aren't of equal value for either mother or baby. When we first meet a mother antenatally we don't say, 'And will you be having a caesar, a vacuum or a natural birth?'. We start by assuming that she'll be having a natural birth. Likewise we shouldn't be saying 'And how do you plan to feed your baby?'. We should assume that she will breastfeed. Is that what you call being pressured? - if so then does that mean we are also 'pressuring' women to have normal births? If we all assume normal right from the beginning (doctors too!), educate about normal, praise women for their strength and ability to have a child then more normal would happen. And breastfeeding is only normal - it isn't special! You say we all have different views and interests ... the philosophy of midwifery doesn't and neither do its best practitioners. Women get pregnant so they will have a child, not to experience childbirth. Safe, optimum, empowering, normal birth is a great way to begin their life with their child... but it's only the beginning. We're doing our best to try to get that experience for as many women as we can - but let us not have fragmentation of care after birthing because it's the 'afterwards' that is most important to most women. But, this conversation started by suggesting great places to go to get brilliant life-changing experiences in midwifery ... I think you would be disappointed about the birthing situation these days in the Netherlands - it may be happening at home, but it isn't ideal birthing and that is borne out by the terrible breastfeeding rates which follow. Warmly Denise At 06:29 PM 18/03/2005 +1100, you wrote: I'm totally for breastfeeding and have breastfed all 3 of my kids. What I am seeing at the moment (can only speak for this area) is so much emphasis on breastfeeding and so little on anything else. Sure - breastfeeding is great and is the 'best' but I believe when a woman feels safe and supported, she will most likely choose the best things for herself and her baby anyway. I know a lot of these mums who are pressured to breastfeed in hospital are giving up as soon as they leave the ward and the hospital are only interested in the fact that they are BF at discharge!!! Hello.. isn't the long term important too. It's time to get back to the basics - women need antenatal education, optimial health, healthy lifestyles etc. They need to be told that pregnancy and birth are normal life events unless otherwise indicated and not something that needs to be controlled or monitiored at every opportunity. When we give women more education, more time, more support, better care.then I am sure a good proportion will make the right choices for their individual circumstances which will include BF. A lot of these women don't even know what will be good for them in the long-term! Of course we all have different views and interests and coming from the outside. this maternity system still has a very long way to go Just my thoughts. Crucify me if you wish. Denise Fisher Health e-Learning http://www.health-e-learning.com [EMAIL PROTECTED]
Re: [ozmidwifery] sharing 'different' info
I wouldn't glorify birthing in the Netherlands too much - their breastfeeding rates are amongst the lowest in the World. A wonderful birth experience is the best way to start (extrauterine) life - but to be breastfed will have a longer term effect on the health and well being of the baby and mother. Denise At 02:39 PM 18/03/2005 +1100, you wrote: Well I would go to Holland and 'See' birth as it should be then I would go to NZ and spend time with Maggie Banks - breech birth and guru midwife!!! I'd then probably go to the US and visit with Ina May Gaskin on the farm! Dreams are free!!! Kiwi Kim *** Denise Fisher Health e-Learning http://www.health-e-learning.com [EMAIL PROTECTED] -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Red heads
http://tinyurl.com/3ubg7 This may have been it Natalie. I didn't note the article at the time, and this is just from a pubmed search I've just done. Cheers Denise At 12:24 PM 22/02/2005 +0800, you wrote: do you know where we could find this article?, as I'd like to know for personal and professional reasons the implications of being a redhead *** Denise Fisher Health e-Learning http://www.health-e-learning.com [EMAIL PROTECTED]
[ozmidwifery] Red heads
You may be right Kirsten. I read a very interesting article (in a medical journal) about how redheads respond to drugs quite differently, and in particular to anaesthetics. I found it fascinating. Denise Who used to be a brunette. :-) At 03:53 PM 21/02/2005 +0930, you wrote: evidently being a red head (naturally of course!) means we have a tendency to bleed more. Also prone to low iron retention. Something to do with a clotting factor missing.Genetic. Its all been researched and seems quite well known. Kirsten A red head *** Denise Fisher Health e-Learning http://www.health-e-learning.com [EMAIL PROTECTED]
[ozmidwifery] suctioning
This is an except from the Health e-Learning online course BE04: Breastfeeding Initiation and the First Week. [quote] Oral aversion as an outcome of routine oropharyngeal or gastric suctioning or intubation is often cited by clinicians as a cause of breastfeeding difficulty, but little research is available to confirm this. Waltman (2004), in a small study of healthy term neonates, showed no benefits of oropharnygeal suctioning but statistically significant slower heart rate for 20 minutes in the suctioned group. A Cochrane review (Halliday, 2004) likewise recommends the routine practice of endotracheal intubation and suctioning of vigorous, term neonates due to the presence of meconium-stained liquor be abandoned as it has no beneficial outcome. Routine gastric suctioning, involving the passage of a tube into the neonate's stomach and aspiration of the contents has been linked to an increased prevalence of functional intestinal disorders in later life (Anand, 2004). Widstrom (1987) noted that gastric suctioning delayed the infant's prefeeding behaviors. However, the most telling outcome of these unnecessary procedures is described by Deneyer et al (1992). Twelve full-term newborns with vague symptoms related to the upper gastrointestinal tract (anorexia, poor feeding, retching, regurgitation, and incessant crying) were diagnosed, by esophagogastroduodenoscopy performed between days 2 and 5 of life, with extremely severe esophagitis (circular ulcerations). When all other possible causes of this condition were eliminated it was determined to have been caused by pharyngeal, esophageal, or gastric suction at birth. [unquote] And the References for the studies cited: Waltman PA, Brewer JM, Rogers BP, May WL. (2004) Building evidence for practice: a pilot study of newborn bulb suctioning at birth. J Midwifery Womens Health.; 49(1):32-8. Halliday HL, Sweet D. (2004) Endotracheal intubation at birth for preventing morbidity and mortality in vigorous, meconium-stained infants born at term (Cochrane Review). In: The Cochrane Library, Issue 3. Chichester, UK: John Wiley Sons, Ltd. Deneyer M, Goossens A, Pipeleers-Marichal M, Hauser B, Blecker U, Sacre L, Vandenplas Y. (1992) Esophagitis of likely traumatic origin in newborns. J Pediatr Gastroenterol Nutr.; 15(1):81-4. Anand KJ, Runeson B, Jacobson B. (2004) Gastric suction at birth associated with long-term risk for functional intestinal disorders in later life. J Pediatr.; 144(4):449-54. Widstrom AM, Ransjo-Arvidson AB, Christensson K, Matthiesen AS, Winberg J, Uvnas-Moberg K. (1987) Gastric suction in healthy newborn infants. Effects on circulation and developing feeding behaviour. Acta Paediatr Scand.; 76(4):566-72. Yes, I know - this could be construed as flagrant self-promotion, and I will apologise to those who are offended by me posting this. I have only done so because it fits exactly into the main topic of conversation on the list at the moment and I feel it adds to the already posted comments. Denise *** Denise Fisher Health e-Learning http://www.health-e-learning.com [EMAIL PROTECTED]
[ozmidwifery] serum protein, stillbirth, delayed lactation
Is anyone in Aus doing any research on serum protein levels during pregnancy? I've just seen this medscape article which is interesting .. http://www.medscape.com/viewarticle/493517?src=mp and learnt of the work of Dawn Hunter from NZ who presented at the Sydney ALCA conference this year who found gross oedema, particularly of the breasts and delayed lactogenesis II in women until their low serum albumin levels approached normal. I'd love to hear of any work going on in this area. Cheers Denise *** Denise Fisher Health e-Learning http://www.health-e-learning.com [EMAIL PROTECTED] -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] gestational diabetes and antenatal ebm
Hi Marilyn I won't swear to it but I don't know that there is any research out there on this practice. However to give newborns their own mother's milk is kinda natural and not really something that we need research to prove is a good thing do we? Wouldn't it be more to the point to ask those who are giving newborns something other than breastmilk to come up with the evidence to prove that what they are doing is not detrimental?? I'd like to see that ... could have them running around in circles for years trying to find anything to support that practice as opposed to giving mother's own colostrum. All you really need proof of is that expressing antenatally won't put a mother into preterm labor, which it won't and I'm sure you'll find plenty out there on that - then ensure that the mothers know how to store and transport their milk safely when the time comes. There's lots more than just giving breastmilk though that can stabilise the newborn's glucose levels quickly and efficiently - starting with undisturbed skin-to-skin on mother's chest from the moment of birthing. I really do implore everyone to think long and hard before scampering around trying to find research articles to prove what is normal and natural while practices using what is detrimental to birthing/breastfeeding/whatever continue without questioning. Please consider looking the perpetrators in the eye and saying First, do no harm! - your practice is not 'normal' - prove to me that it is doing no harm!! Cheers Denise *** Denise Fisher Health e-Learning http://www.health-e-learning.com [EMAIL PROTECTED] -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] Homer
You could do worse Ping - Homer was quite a noted author (Odyssey, Iliad) and in this esteemed group of educated men and women, I can't think who else you could be thinking of ;-) At 01:52 PM 7/11/2004, you wrote: Hi Rita, Believe me, I thought Homer is my middle name ; -)) Ping ** Denise Fisher [EMAIL PROTECTED] http://www.health-e-learning.com **
[ozmidwifery] cold epidurals
Someone recently mentioned the advent of 'cold epidurals', where the epidural is put in place before an induction is started. I'd not heard of this before and was shocked! But is it unreasonable? Vincent Chestnut (1998) gave the administration of IV oxytocin intrapartum as the most useful predictor of which women will request epidural anaesthesia during labour. What's the incidence?? I don't know but guess it's pretty high. When would be the best time to put an epidural in - when a woman is distressed and moving experiencing strong labour pain, or before it all starts and she is lying still and quiet? It's the outcome here, ie use of cold epidurals, that horrifies me when it should be the number of unnecessary inductions or perhaps the way inductions are conducted that force a woman into acute pain so quickly that should be reviewed. It's a while since I've worked in birthing suite. Those of you who are familiar with inductions why do they HAVE to be so rugged? Denise *** Denise Fisher, MMP, IBCLC Health e-Learning http://www.health-e-learning.com [EMAIL PROTECTED] -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] lactobacillus and candida
Thought you may find this article of interest: http://bmj.bmjjournals.com/cgi/content/full/329/7465/548 To avoid developing vulvovaginal candidiasis after antibiotic use, many women use complementary and alternative therapies, including lactobacillus in various forms (e.g., oral capsules, vaginal suppositories, yogurt). In this Australian study, 278 women (age range, 18-50) with nongynecologic infections were randomized to receive one of four regimens during 6 days of antibiotic use and 4 days thereafter: an oral lactobacillus-containing powder (one-half teaspoon twice daily) and a lactobacillus-containing vaginal suppository (once daily at bedtime); oral lactobacillus and vaginal placebo; vaginal lactobacillus and oral placebo; or double placebo. Women completed symptom surveys and provided self-collected vaginal-swab specimens at baseline and either 4 days after completing their randomized treatment or when symptoms developed. Cases were defined as women with symptoms plus candida isolated from the follow-up swab; asymptomatic women with positive cultures were not considered cases. The trial was terminated when enrollment was 62% complete because interim analysis showed no evidence of treatment benefit. Of the 235 women with complete outcome data (85% of those randomized), 55 developed symptomatic vaginal candidiasis. The incidence was 24% with oral and vaginal lactobacillus, 24% with oral lactobacillus and vaginal placebo, 29% with vaginal lactobacillus and oral placebo, and 17% with double placebo. The resulting odds ratios for developing candidiasis were 1.06 for oral lactobacillus and 1.38 for vaginal lactobacillus (both ORs were nonsignificant). Comment: Despite conventional wisdom encouraging women to use lactobacillus preparations to prevent yeast infections after antibiotic use, this small but well-designed study demonstrated no benefit from this practice. In fact, the findings suggest the potential for harm. Based on this study, clinicians should discourage patients from using these products to prevent post-antibiotic yeast infections. *** Denise Fisher Health e-Learning http://www.health-e-learning.com
[ozmidwifery] Introduction and request
Hi everyone I've just recently re-joined ozmidwifery after a long absence and have been 'lurking' for a few days. I have a request now so thought I should re-introduce myself. I live in Brisbane and have been a midwife since 1980, training at King Edward in Perth and have worked in Queensland and Tasmania. For the last few years I have been involved entirely in education, setting up my own training company, Health e-Learning, which, as the name implies, delivers education for health professionals via the internet. At this stage most of the courses we offer are on lactation. My request: someone from this list just sent an email about a study on epidurals and I deleted it before I realised that I really did want it :-/ Would someone please send it to me again at my private email address. Thank you Denise *** Denise Fisher Health e-Learning http://www.health-e-learning.com [EMAIL PROTECTED] -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] pain relief/epidural article
Thank you. Denise At 11:49 AM 3/11/2004 +1100, you wrote: Here's the article again for Deinise others who may have missed it. *** Denise Fisher Health e-Learning http://www.health-e-learning.com [EMAIL PROTECTED] -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] pain relief/epidural article
Well said Andrea. I've just finished researching the effects of birthing interventions for the review of one of our online courses and have been surprised by the number of women who have told me that they didn't know that epidurals had ANY effect on the baby, and of course only very rare effects on them well it just ain't so! And they think this because that is what they are told .. by doctors. OK I'm generalising - I know we do have many good doctors out there who tell it like it is ... could those people please forgive me. Denise At 02:45 PM 3/11/2004 +1100, Andrea wrote: What many women don't realise is that when they choose an epidural to avoid an opioid drug they are not told that the epidural medication is a mixture of an anaesathetic (usually bupivacaine) and an opioid, usually Fentanyl. Many midwives I have spoken to are surprised about this as well - they have just not considered that even this amount of an opiate can have an impact on the woman and he baby. *** Denise Fisher Health e-Learning http://www.health-e-learning.com [EMAIL PROTECTED] -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
