this was this week
Mother's nipples hurt during latch of newborn and ended up pointy like a lipstick.
Nurses told mother that the baby looked tongue-tied. They recommended checking with the IBCLC. ((Yay, for the nurses!))
IBCLC confirmed the tongue-tie. Referred her to me. ((Right-on!))
PEDIATRICIAN even confirmed it was tongue-tie!! He referred to ENT!
ENT scheduled baby to have frenotomy relaeased in out-patient center. :(
Mom's nipples still hurt.
Out-patient surgery center notified parents that they don't take newborns. Either they can re-schedule at 6 months or go to the operating room.
Waiting won't help breastfeeding TODAY.
Anesthesia is not necessary.
Mom came to me. Determined to breastfeed.
She explained all this to me. Showed me the baby's tongue and her lipstick shaped nipple after latching.
A very simple snip in the office released the frenulum.
The baby went to breast.
No lipstick shape to the nipple.
Everyone Lived Happily Ever After.
Saturday, January 21, 2012
Posted by Denise Punger MD IBCLC at 9:55 AM
Thursday, January 12, 2012
Addendum1/22/12 : I have been sent updated links and comments in response to this post. My post is outdated. Until I can update, read through the comments. As I have found out there ARE guidelines from LLL. Not too many people are aware that leaders can discuss the pros and cons of milk-sharing when it is brought up. Per the guidelines it is very appropriate for a leader to refer to a health care professional for a discussion of medical pros/cons of informal milk sharing. That is where I would come in. I want to evaluate why the mother can not meet the needs of her baby (low supply or medication exposure or other reason), can it be corrected and if not discuss the options of what to supplement with (donated milk, home-made formula, commercial formula, cow's milk, goat's milk, or vegan mylks with and how to supplement it (bottle vs supplemental system, etc..). Human Milk 4 Human Babies is a commerce free site on facebook to offer your extra milk or seek potential donors. Look for the global network and your regional group.
From my attendance at the recent conferences it is apparent that even some of the breastfeeding doctors can be adamantly opposed to milk sharing. La Leche League does not support informal milk sharing either.
It would be very reasonable to support milk sharing amongst friends who have known blood tests and are obviously healthy.
If the mother is feeding milk to their own baby, and recipient knows both the donor mother and the baby, it sounds responsible for a breastfeeding group to support informal milk sharing. Then go on to clarify if you must that if you don't know the mother and the baby that carries risks of the unknown.
There is VERY little that makes milk bad. I'd be afraid of the risks of formula and increased illness.
If you don't know the donor you can get to know them.
The only reason I once heard for La Leche League not supporting the use of donor milk was desiring credibility to new-comers and the public.
There is much more awareness now on the benefits of milk-sharing, it is time to update policy and make a huge positive impact.
I could also accept if a new policy stated that both mothers and both babies be monitored for good health through out the donation period. The donor mother's prenatal labs with HIV should suffice (HIV is a topic for another post). A donor baby who is healthy and growing, labs are not necessary. We just want to see that the baby won't be compromised if mother shares milk. The recipient mother should have an evaluation on why she can't produce enough milk and optimize her own production.
Doctors get blamed for making decisions based on pharmaceutical and financial interest. I have wondered if the hold out for breastfeeding groups to accept donor milk has something to do with collaboration and survival of milk banks. I don't know if this is fact, so don't quote me. It's just a thought.
Pasteurized milk serve a special community: the preemie babies and research. It is not easy to get pasteurized milk out to the communities healthy babies.
I will take this one step furthur. I have been a Raw food advocate. The same principle applies to breastmilk. While pasteurized breastmilk is much better than formula. Minimally processed breastmilk has the LIVE enzymes. I also support the use of minimizing the handling of fresh milk.
If anyone has milk to share at this time, I can probably find a home for it.
I do not support buying milk from Craig's List and Social Media.
Posted by Denise Punger MD IBCLC at 9:53 PM
Sunday, January 8, 2012
Posted by Denise Punger MD IBCLC at 8:52 PM
Thursday, January 5, 2012
Over the New Year's Weekend in my blog reader, I noticed a lot of blog authors reposting their favorite blog post of the year. It made me realize how long it has been since I have added anything here. My kids don't like me taking their photos and they like more privacy. I get that. Although I do plan to update about their homeschooling and other activities very relevant, I am not using this so much to update family and friends. I will use it for birth, breastfeeding, and homeschooling mostly.
I've been actively following a facebook group for the La Leche League of the Treasure Coast. We have over 200 enthusiastic mothers standing up for their breastfeeding and asking tons of questions to make good choices. I love seeing so many involved mothers in one place!
I've been to two breastfeeding conferences this fall. I am planning to attend a morning conference in Miami geared towards baby-friendly and physicians this weekend.
I've been going to some local LLL meetings and events. I have an events tab up above on my blog. I like meeting you and seeing your babies out of the office, so hope to see you there!
In my office we have moved from paper charts to EMR (electronic medical records). This continues to be a big transition.
I frequently get e-mail like this:
I received your name from a local IBCLC after being horrified by my current ped's advice. After taking a look at your website, I really hope you can make room for my baby and I in your practice. Here is our situation...
We exclusively breastfeed, cloth diaper, and babywear, and I consider myself very knowledgeable in all 3 areas. Breastfeeding is extremely important to us and I plan on doing baby led weaning.
Now at 6 months, she hasn't gained anything since 4 months. We question vaccines. We'd like to have an opinion from someone else on vaccines, weight gain, etc...
PLEASE be our new doctor!!!
I carefully keep tabs of the amount of active patients in my practice. I leave space each week to offer appointments to those moms who share the same beliefs as I. I hope to fill ALL those spaces with moms and babies who need well visits or consults.
Another question I get asked:
We don't go to the doctors much, but it would be nice to establish with a doctor just in case something comes up. Can my family come to you without getting caught up with vaccine schedules and other demands.I am very flexible. I know there are many families who take good care of themselves. I know that they don't get sick much and have remedies they use before calling a doctor. That is the goal! You take care of yourself. I only make recommendations and/or support you your choices. As long as we have good communication and what kind of situations you may need medical care, I find this flexibility works.So despite the blog being quiet, I've have not been. One more thing... I don't know why I have problems with fonts and laying out photos. It doesn't make it fun to blog. When the fonts and spacing are no longer easy to deal with. I can easily kill a lot of time figuring out what is wrong with the spacing, but I am going to hit publish now...Sigh.
Posted by Denise Punger MD IBCLC at 8:08 PM