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Mothering Magazine Sponsored Chat with Dr. Jack Newman -- Dr. Newman graduated from the University of Toronto medical school in 1970, interning at the Vancouver General Hospital. He did his training in paediatrics in Quebec City and at the Hospital for Sick Children in Toronto from 1977-1981, to become a Fellow of the Royal College of Physicians of Canada in 1981 as well as Board Certified by the AAP in 1981. He has worked as a physician in Central America, New Zealand and South Africa. He founded the first hospital based breastfeeding clinic in Canada in 1984. He has been a consultant for UNICEF for the Baby Friendly Hospital Initiative, evaluating the first Baby Friendly Hospitals in Gabon, the Ivory Coast and Canada.

Dr. Newman was a staff paediatrician at the Hospital for Sick Children emergency department from 1983 to 1992, and was, for a period of time the acting chief of the emergency services. However, once the breastfeeding clinic started functioning, it took more and more of his time, and he eventually worked full time helping mothers and babies succeed with breastfeeding. He now works in several clinics around the city of Toronto.

Dr. Newman has several publications on breastfeeding, and in 2000 published a help guide for professionals and mothers on breastfeeding, called, Dr. Jack Newman's Guide to Breastfeeding in Canada (revised edition, January 2003), and The Ultimate Breastfeeding Book of Answers in the US. In 2005, he and others brought out a DVD for breastfeeding called Dr. Jack Newman’s Visual Guide to Breastfeeding.
www.mothering.com
10/7/05

52 mothers in attendance!!

Books by Dr. Newman:

12:09:59 Webmama_Tina ok....so today i am soooooo happy to welcome dr jack newman as our guest speaker!
12:10:08 JackNewman Pleased to be here.
12:10:08 KristaJoy ?
12:10:08 Webmama_Tina dr newman....why don' t you introduce yourself?
12:10:18 Webmama_Tina give us a little background on you and your expertise
12:10:26 Webmama_Tina don't forget to share any links and books that you have
12:10:33 KristiMetz ?
12:10:41 Webmama_Tina and when you're done just let us know you're ready for your first question
12:10:48 gretchenp ?
12:10:59 Webmama_Tina angie is our queuekeeper and is gathering the names from the question marks being posted and will let ya know who's up when.
12:11:09 curlyfry ?
12:11:17 Webmama_Tina please remember, mamas, to not go until angie says its your turn. :)
12:11:24 the4manz3 ?
12:11:28 nakagain ?
12:11:45 JackNewman Okay, I'm a paediatrician (not English spelling).  I work in Toronto.  I've run a breastfeeding clinic in various hospitals in the Toronto area, and have done so for 21 years.  In that time we've seen about 20,000 mothers with their babies.  I've written a book on breastfeeding. Dr. Jack Newman's Guide to Breastfeeding (Ultimate Breastfeeding Book of Answers in the US) and we've just put out a DVD, Dr Jack Newman's Visual Guide to Breastfeeding.
12:12:16 JackNewman That should be note English spelling""
12:14:35 PrincessCass are we now in the right spot?
12:14:53 JackNewman I think so, but everyone else seems to have fallen silent.
12:15:01 MOD_Angie upcoming chatter(s):  mommyk  reeran  KristaJoy  KristiMetz  gretchenp  curlyfry  the4manz3  nakagain
12:15:18 LydiaR ?
12:15:45 Shell_ell ?
12:15:52 MOD_Angie please have your question ready when your name is called, Thank You!
12:15:52 Webmama_Tina we're listening to you dr newman. :)  are you ready for your first question?
12:16:00 lolarose2223 ?
12:16:03 JackNewman I'm ready.
12:16:04 mishiemumma ?
12:16:07 Webmama_Tina okey dokey
12:16:16 Webmama_Tina looks like mommyk is up first
12:16:19 mommyk my baby was jaundice and the doctor had her on a billy light and also told me to only nurse every four hours and then give her a bottle of water in between, was that necissary?
12:16:42 Webmama_Tina and don't mind me as i post welcomes and info for newcomers...just keep going.... :)
12:17:06 mommyk we had an aweful time nursing and had to quit after 6 weeks, just wondering if that contributed?  I think our make problem was latching on
12:17:23 Webmama_Tina Welcome to this week's Mothering Sponsored chat! This is a moderated chat. Please make sure you read and fully understand the Moderated Chat Instructions before participating in this chat. Instructions can be found here: http://www.mommychats.com/modrules.htm  ...A Friendly Reminder: Please do not post unless it is your turn to ask a question. If you have a question, please post a single ?" and you'll be added to the queue. Have your question ready when your name is called."
12:17:43 JackNewman Not only wasn't it necessary, it was completely the wrong thing to suggest.  If the baby is breastfeeding well and gaining well and the urine is clear like water, there is nothing to do but reassure the mother.  Babies should not be fed by the clock.  And they don't need water.  In fact, water, especially by bottle can make things worse.  See our patient handouts at the websites www.thebirthden.com/Newman.html  or www.gentlemothering.ca .  Look for Jaundice.
12:17:43 PrincessCass ?
12:17:55 amica ?
12:18:18 mommyk she was not gaining weight
12:18:20 JackNewman Also www.breastfeedingonline.com.  These are not my websites incidentally, but have my material on them.  There are also video clips that show breastfeeding techniques.
12:18:33 mommyk thanks
12:19:03 JackNewman Then the idea is not to feed by the clock and give water, but rather fix the breastfeeding.  See the Protocol to increase breastmilk intake by the baby, which you can find at those websites, and use the video clips to help you use the Protocol.  Get good hands on help as well.
12:19:03 reeran My daughter is 15 mos and I conceived her doing infertility iui.  I would like to have another since I'm already 41 but hate to stop bfeeding.  The RE tells me I have to stop cause of meds.  Is this so? And can you share your thoughts about this, if any?
12:19:40 Webmama_Tina hold on reeran....
12:19:41 mommyk ?
12:19:45 Webmama_Tina we're taking turns
12:19:51 reeran sorry
12:19:51 Webmama_Tina right now it is mommyk's turn with dr newman
12:19:54 Webmama_Tina no worries
12:19:57 JackNewman Not true.  There is hardly any medication that requires you to stop breastfeeding, including medications for induce pregnancies.  Some of these medications can decrease milk supply, but is not a reason to stop breastfeeding.
12:20:18 mommyk I also had a quetsions about the shape and make up of my breat contributing to our difficulty
12:20:56 Webmama_Tina ok mommyk...did your first question get answered?
12:21:02 mommyk there is very little fatty tissue and the areola's are very large, about 4 inch in diameter and there is hair around on my nipple around the edge
12:21:06 JackNewman Well, go ahead, but let me tell you that most of these things about shapes of breasts probably mean very little.  The reason mothers have difficulties is that they get advice like feed the baby on a schedule and give water.
12:21:24 debbiej74 ?
12:21:40 Webmama_Tina dr newman...it can be confusing when others jump in out of turn...some people are new to these chats...so just defer to angie as to who's turn it is to ask a question and we can keep things organized. :)
12:21:45 Webmama_Tina and mommies, here's the info again...
12:21:46 JackNewman You may have what some people call insufficient breast tissue".  I've seen this often, and often enough the mothers produce plenty of milk anyway.  But see the Protocol."
12:21:49 Webmama_Tina Welcome to this week's Mothering Sponsored chat! This is a moderated chat. Please make sure you read and fully understand the Moderated Chat Instructions before participating in this chat. Instructions can be found here: http://www.mommychats.com/modrules.htm  ...A Friendly Reminder: Please do not post unless it is your turn to ask a question. If you have a question, please post a single ?" and you'll be added to the queue. Have your question ready when your name is called."
12:22:02 Tziona ?
12:22:25 mommyk thanks, just happy to have such an expert in front" of us !"
12:23:14 Webmama_Tina ok mamas, we have TONS of questions today...lets do this orderly so that we can get to as many as possible
12:23:24 Webmama_Tina At this time, the queue is full. Questions already in line will be asked, but we cannot take anymore today. Sorry for the inconvenience.
12:23:34 Webmama_Tina if we get to all these questions then we'll take more
12:23:35 Webmama_Tina :)
12:23:51 Webmama_Tina ok who's next angie?
12:24:20 MOD_Angie upcoming chatter(s):  KristaJoy   KristiMetz    gretchenp   curlyfry   the4manz3    nakagain    LydiaR    Shell_ell     lolarose2223    mishiemumma     PrincessCass    amica      debbiej74     Tziona
12:24:37 KristaJoy me now?
12:24:42 MOD_Angie yes
12:24:50 KristaJoy great! First of all, I'm honoured to be chatting with you, Dr. Newman.  :-)  I'm across Lake Ontario from you in Rochester, NY, but a native of Saskatchewan.
12:25:03 Webmama_Tina Friendly Reminder: Please do not post unless it is your turn to ask a question. If you have a question, please post a single ?" and you'll be added to the queue. Have your question ready when your name is called. THANKYOU! :)"
12:25:12 JackNewman Great.  Maybe I'll take the boat over one day.
12:25:17 Webmama_Tina (just posting reminders since we are so busy today.)  :)
12:25:24 KristaJoy My question is one concerned bm composition
12:25:36 KristaJoy I recently did some research regarding nutrition/diet and fat in dairy cows.  It is generally accepted in that field that diet can affect fat content, poor diet meaning lower fat and better diet higher fat up to a biologically pre-determined percentage
12:26:20 KristaJoy LL and other sources say that unless a mother is severaly malnourished, diet doesn't affect composition
12:26:30 KristaJoy This seems counter-intuitive to me on many levels and especially now that I have found out that other mammals' fat content can be varied according to diet
12:26:38 KristaJoy I'm wondering what your views are on this? Do you believe that nutrition/diet is important to maintain high quality bm?  Should this be something emphasized more in bfding education?
12:27:04 Webmama_Tina just a note: we may or may not get to all those in the queue today...hang tight...there's lots of mamas with questions. :) please do not speak until angie says its your turn. thankyou for helping us keep things orderly. :)
12:27:54 JackNewman This is the evidence that we have from a study done in Ethiopia and in Sweden that showed that women in Ethiopia had more or less the same milk composition as women in Sweden.  Only the amount they produced was less.  But I agree, this sounds counter-intuitive.  Nevertheless, what is true of dairy cattle is not necessarily true of humans.  Cows were bred to produce more milk and perhaps respond better to diet.
12:28:23 mairead ?
12:28:26 JackNewman But, I should say that most studies on breastmilk composition are not worth much.  Depending on the study you get widely different results.
12:28:28 Webmama_Tina At this time, the queue is full. Questions already in line will be asked, but we cannot take anymore today. Sorry for the inconvenience.
12:28:56 KristaJoy Good point.  I've heard of the Ethiopia study before.  It just does seem so.... wrong?  But thanks for your thoughts.  Maybe this question will be more fully studied in the future.  my thoughts were that we might NOT want to look at it, honestly,
12:29:05 KristaJoy b.c it might discourge moms with imperfect diets.
12:29:07 marcia_cunningham ?
12:29:31 KristaJoy (I'm done, thanks!)
12:29:36 MOD_Angie upcoming chatter(s): reeran,  KristiMetz, gretchenp, curlyfry, the4manz3, nakagain, LydiaR, Shell_ell, lolarose2223, mishiemumma, PrincessCass, amica, debbiej74, Tziona
12:29:38 JackNewman I don't think so.  Women in Ethiopia and other parts of Africa have far fewer problems breastfeeding than well nourished North American women.
12:29:42 Webmama_Tina ok reeran, you're up!
12:30:05 JackNewman I think I answered reeran's question.
12:30:27 Webmama_Tina okey dokey....
12:31:00 KristiMetz me now?
12:31:05 reeran Yes I think you did.  Thank you Dr. Newman.  You're like a god to the lactation consultants here in South Bay, southern CA
12:31:19 Webmama_Tina yup just waiting for reeran's response...yes, go for it kristi
12:31:30 MOD_Angie upcoming chatter(s): KristiMetz, gretchenp, curlyfry, the4manz3, nakagain, LydiaR, Shell_ell, lolarose2223, mishiemumma, PrincessCass, amica, debbiej74, Tziona
12:31:48 Webmama_Tina At this time, the queue is full. Questions already in line will be asked, but we cannot take anymore today. Sorry for the inconvenience.
12:32:21 KristiMetz OK.  First, Dr. Newman, let me thank you for being such an incredible resource for bf'ing moms everywhere!  My question : I've taken domperidone for 2 years and am currently weaning myself off of it... I'm glad I took it, and have no regrets...
12:32:32 mammameegan Mothering_Mag
12:32:35 KristiMetz (I took it due to breast reduction surgery)
12:32:39 JackNewman Domperidone is a great medication.
12:32:39 Webmama_Tina remember to have your questions ready, mamas...that will help speed things up since there's so many that want to talk to dr newman today. :)
12:33:04 JackNewman But, like all medications should only be used if necessary.
12:33:24 mommy2zavin ?
12:33:28 KristiMetz However, I'm wondering to what degree taking a fairly high dosage of domperidone (120 mg) for a long time is, in your view, safe.  I know lots of women do it... but what do we know about its long term safety?
12:33:30 Webmama_Tina At this time, the queue is full. Questions already in line will be asked, but we cannot take anymore today. Sorry for the inconvenience.
12:34:30 JackNewman Well, let's put it this way.  People taking domperidone for stomach disorders, some of them, have been taking domperidone for 20 years.  It seems safe, but one can never be 100% sure.  I have had mothers on it for 2 or 3 years, without apparent problems.
12:34:53 KristiMetz Ok, thank you dr. newman!
12:34:54 JackNewman By the way, it is common for gastroenterologists here in Toronto to use 120 mg a day.
12:35:16 KristiMetz I didn't realize that it was common for people to take so much and for long periods of time.  That is very encouraging!
12:35:31 MOD_Angie upcoming chatter(s): gretchenp, curlyfry, the4manz3, nakagain, LydiaR, Shell_ell, lolarose2223, mishiemumma, PrincessCass, amica, debbiej74, Tziona
12:35:39 Webmama_Tina ok gretchen, you're up!
12:35:41 gretchenp My daughter is about to turn one.  She currently nurses about 4 times a day, none at night.  I'd like to start nudging her toward 2 nursings, AM/wakeup nursing and PM before bed nursing.  Any suggestions on how to do this gently?
12:35:42 JackNewman Well, people who are taking them for stomach disorders, like diabetics, are on it for life.
12:36:06 gretchenp And how do I get her to take a nap without nursing?
12:36:57 JackNewman The gentlest way is to let her lead the way.  Why are you working to get her to take fewer nursings.  Nursing a toddler can be the best time for nursing both for the mother and the child.  Why do you want her to nap without nursing.  I know the paediatricians say that you should, but there is no good reason to not nurse a baby to sleep.
12:37:34 gretchenp Frankly, I'm getting emotionally ready to not be a moo cow any more.
12:38:02 gretchenp I love nursing her, don't get me wrong...
12:38:28 JackNewman Don't look at it that way.  Look at it as a loving relationship between two people who love each other.  You will see, if you let yourself go, you will see how wonderful it can be when she says to you, I love your milk, mummy"."
12:38:36 gretchenp It's just so hard dealing with the pumping on the days I work or if I have an evening meeting
12:39:12 JackNewman Don't pump.  Why bother pumping?  I personally think pumping destroys a lot of what is good about breastfeeding.  She will be fine.
12:39:27 gretchenp If I just don't pump on those days, will I have enough milk on the days we are together?
12:39:59 JackNewman Your body adjusts.  It should work.  Pump for comfort only.  Or get someone to show you how to express by hand, a much easier process sometimes.
12:40:25 lrh Mothering_Mag
12:40:27 gretchenp Ok, I'll try that.  Thanks!  Next...
12:40:28 JackNewman If the milk supply does decrease, she will decrease her nursing on her own.  And you won't have to do anything.
12:40:46 MOD_Angie upcoming chatter(s): curlyfry, the4manz3, nakagain, LydiaR, Shell_ell, lolarose2223, mishiemumma, PrincessCass, amica, debbiej74, Tziona
12:40:53 curlyfry I am 3 weeks post partum and wondering how long I should wait to introduce a bottle of breastmilk, since I may be going back to work part time starting in January. I don't want to cause any nipple confusion but don't wana wait to long to introduce bottles
12:41:25 curlyfry I'm also a pumping failure! Can't relax enough to do it.
12:42:00 lrh I'm wondering how long thawed breast milk from the freezer can last in the fridge?
12:42:07 LadyTomoe hello
12:42:10 curlyfry (nursing at keyboard, by the way)
12:42:10 Webmama_Tina lrh we're taking turns
12:42:15 Webmama_Tina Friendly Reminder: Please do not post unless it is your turn to ask a question. If you have a question, please post a single ?" and you'll be added to the queue. Have your question ready when your name is called. THANKYOU! :)"
12:42:18 Webmama_Tina At this time, the queue is full. Questions already in line will be asked, but we cannot take anymore today. Sorry for the inconvenience.
12:42:36 Webmama_Tina sorry mamas, we have a ton of mamas waiting in line to ask dr newman a question...and we're trying to keep this orderly
12:42:37 Webmama_Tina :)
12:42:55 lrh sorry  :)
12:43:08 Webmama_Tina *pointing to the tremendous line of patiently waiting mamas standing behind curlyfry, who's turn it is to talk right now. :)  *
12:43:14 JackNewman This is a difficult question.  I know it won't do you any good but really all you chatters out there from the US should lobby your representatives to get decent maternity leave.  In Canada mothers have 1 year maternity leave.  No need to pump.  Okay, there are ways of dealing with this.  The first is to wait a little longer, at least 6 weeks.  You have another two months.  Cup feeding can also be tried.  So can having the baby brought to you at work.  Many babies actually will wait for their mothers.  So they nurse at when the mother is home (at night) and sit around during the day.
12:44:03 JackNewman If you have trouble pumping, domperidone can help.
12:44:25 JackNewman See the chapter in my book on maternal baby separation.
12:44:33 curlyfry But, if she's with my mom or a sitter, the reality is, she will need to learn to take a bottle, right?
12:44:57 curlyfry I will only be working PT, by the way.
12:45:34 JackNewman No, she can drink from a cup or, as many babies do, they wait for the mother.  But it is best to wait until the baby is 6 weeks old to start a bottle.  All mothers are working 24 hours a day.  If you mean for money, yes, that will help, but maybe you should consider waiting before going back to your outside job.
12:46:00 curlyfry Thanks so much.
12:46:03 MOD_Angie upcoming chatter(s): the4manz3, nakagain, LydiaR, Shell_ell, lolarose2223, mishiemumma, PrincessCass, amica, debbiej74, Tziona
12:46:10 Webmama_Tina ok the4manz3
12:46:12 the4manz3 My 3 month old has started choking, crying and pulling off my breast when my milk lets down.  She sleeps all night (10-12 hours) and takes a long nap (3 hours) during the day. Should I pump during these stretches to keep my breasts from getting so full?
12:46:15 Webmama_Tina :)
12:47:04 JackNewman I don't think that's a good idea. If you do that, your body will not adjust to your baby's requirements, but continue overproducing.  Pump only for relief of discomfort and then only the minimum necessary to feel comfortable.
12:47:46 the4manz3 Why do you think she is choking etc?
12:48:44 JackNewman Well, your explanation is perhaps correct, but babies usually choke earlier, before 3 months.  But maybe your supply has suddenly increased for some reason.  Or perhaps her latch has become less good and she cannot control the flow as well.
12:49:26 the4manz3 I had tried feeding her on a schedule and figured that was a problem so now I'm feeding her more often
12:49:28 JackNewman See the colic handout at the previously mentioned websites.  Lying down with the baby often helps, especially when you know when she is more likely to choke.
12:49:45 JackNewman Feeding on a schedule is rarely, if ever, the solution to a breastfeeding issue.
12:50:03 the4manz3 the problem started after we tried a schedule
12:50:10 JackNewman QED
12:50:18 the4manz3 maybe things will even out now
12:50:28 JackNewman That's math talk for what was to be proved.
12:50:32 Webmama_Tina 10min left in this chat...unless the dr has more time ...up to you entirely dr. :)
12:50:37 the4manz3 thanks!
12:50:49 JackNewman Let's do the queue and then finish.
12:50:52 nakagain How much education on breastfeeding/lactation do peds. really go through in medical school?  I have yet to meet a ped. who has had accurate breastfeeding advice.  Is there a way to educate peds on such an important issue or is it a lost cause?
12:50:52 Webmama_Tina ok
12:50:58 MOD_Angie upcoming chatter(s): nakagain, LydiaR, Shell_ell, lolarose2223, mishiemumma, PrincessCass, amica, debbiej74, Tziona
12:51:02 Webmama_Tina there ya go, she beat me to it, lol
12:51:59 nakagain I see way too many women fail including myself(w/1st baby) because no one toild me hypo thyroid was the cause of my milk supply issues.
12:52:32 JackNewman Something's wrong.
12:52:38 nakagain sorry nak(nursing at keyboard)
12:53:12 JackNewman I was trying to send messages, but they didn't go.  Okay, here again.  Most pediatricians get absolutely no practical training on breastfeeding.  They should admit they know nothing and stop telling mothers nonsense.
12:53:41 JackNewman It's not a lost cause, but we have to work on the students.  Not much hope for most paediatricians.
12:53:52 nakagain I agree but they give out horrible advice..what can we do?  I get heart broken
12:54:52 JackNewman Mothers need to educate themselves.  May I suggest my book?  The websites.  And remember, doctors give advice, not commandments.  Mothers have the right not to follow advice or ask for another opinion.
12:55:18 nakagain thanks
12:55:39 MOD_Angie upcoming chatter(s): LydiaR, Shell_ell, lolarose2223, mishiemumma, PrincessCass, amica, debbiej74, Tziona
12:55:39 Webmama_Tina dr newman can you post the web links and the book titles again for those who came late?
12:55:45 LydiaR Dr. Newman, great to speak to you this way again. I have seen your presentation on 'breastfeeding in the modern world' (or something like that) twice now; at an LLL-International-Conference and at a Dutch IBCLC conference. That is what my question is about
12:55:45 Webmama_Tina lydia you're up!
12:55:51 Webmama_Tina oh you mamas are on the ball, lol
12:56:29 LydiaR In this presentation you show (at the end) a picture of a mother breastfeeding at the battlefield. It is from an old Argentinan? sage.
12:56:59 LydiaR Do you know which picture I mean (you comment on it with: you can even BF when you are dead) and, even more important, do you know where I can find it???
12:57:10 JackNewman Good websites with video clips and our information: www.thebirthden.com/Newman.html  or www.breastfeedingonline.com  or www.gentlemothering.ca .  The book is called Dr Jack Newman's Guide to Breastfeeding (Ultimate Breastfeeding Book of Answers in the US), the DVD is called Dr. Jack Newman's Visual Guide to Breastfeeding.
12:57:49 JackNewman I can send it to you.  Email me and I'll copy it and send it.  The photo of a mother breastfeeding while holding a rifle is from Nicaragua.
12:58:08 Marina anybody here?
12:58:11 Marina *confused*
12:58:18 Webmama_Tina Marina we are taking turns asking the dr our questions...
12:58:22 Webmama_Tina currently the queue is full
12:58:28 Webmama_Tina Friendly Reminder: Please do not post unless it is your turn to ask a question. If you have a question, please post a single ?" and you'll be added to the queue. Have your question ready when your name is called. THANKYOU! :)"
12:58:30 Marina I was in the breastfeeding room
12:58:31 LydiaR Aha, yes, I know the picture with the rifle. I am seachring for the picture of a mother lying dead on a battlefield.
12:58:33 Webmama_Tina glad you made it though! :)
12:58:42 LydiaR I'll email you personally. Thank you very much.
12:58:47 LydiaR Next :-)
12:58:59 Webmama_Tina shell_ell you're up!
12:59:08 MOD_Angie upcoming chatter(s): Shell_ell, lolarose2223, mishiemumma, PrincessCass, amica, debbiej74, Tziona
12:59:19 Shell_ell trying to post...
12:59:42 Shell_ell In your opinion, is there such thing as a woman who simply cannot make enough milk? Or is every willing nursing mother able to produce enough if she works hard enough?
13:00:11 Shell_ell My midwife and the IBCLC I have been working with do not believe I will be able to produce enough on my own (and are suggesting medication, which I’m trying to avoid) but my son’s pediatrician says otherwise
13:00:20 Shell_ell . Who do I believe? Is there hope that I will be able to give my son enough milk as time wears on, or am I going to have to count on supplementing and/or medication? I am doing everything ‘right’ so far as I can tell.
13:01:43 JackNewman There are definitely women who cannot produce enough milk.  They are a small minority, but they exist.  However, in most cases women who do not produce enough milk, it's because the baby is not getting what is available.  Go to the previously mentioned websites.  Use the Protocol to increase breastmilk intake by the baby and use the video clips to help you use this Protocol.  If your baby does well, fine.  If not, better to breastfeed with a lactation aid than not breastfeed.  Some breastmilk is better than none, and there is more to breastfeeding than milk.
13:02:22 Shell_ell I agree, thank you!
13:02:49 Webmama_Tina lolarose, you're up!
13:03:00 MOD_Angie upcoming chatter(s): LydiaR, Shell_ell, lolarose2223, mishiemumma, PrincessCass, amica, debbiej74, Tziona
13:03:00 Webmama_Tina ah ha...
13:03:06 MOD_Angie oops
13:03:12 MOD_Angie upcoming chatter(s): lolarose2223, mishiemumma, PrincessCass, amica, debbiej74, Tziona
13:03:13 Webmama_Tina she had PM'd me that she was having computer difficulties
13:03:20 Webmama_Tina so i have her question if she can't post...
13:03:32 Webmama_Tina you there lolarose?
13:03:38 lolarose2223 just got back
13:03:43 Webmama_Tina ah ha, ok go for it
13:03:46 lolarose2223 this is so frustrating
13:03:53 Webmama_Tina i bet...do you want me to just post it for ya
13:03:54 Webmama_Tina ?
13:03:55 lolarose2223 please accept my apologies for the delay
13:04:02 lolarose2223 please do:)
13:04:03 Webmama_Tina not much of a delay, don't worry...
13:04:15 Webmama_Tina ok here's her question cuz she may get kicked off the internet again....
13:04:48 Webmama_Tina [lolarose2223] My son just turned 10mos and was exclusively BF unti 8 mos.-milk supply drastically dropped when solids were introduced-pediatrician put me on Reglan about 6wks ago-what are your views on this med? Double pumping only yields about 2oz for me in 30 min
13:05:26 lolarose2223 My son's behaviour tells me he is not ready to discontinue BF
13:05:26 Webmama_Tina [lolarose2223] i am desperate   10:51 AM [lolarose2223] baby is obviously not ready to be weaned by his behaviour
13:06:36 JackNewman First of all, don't look at how much you can pump.  That only tells you how much you can pump, not what a baby breastfeeding well can get.  Secondly, see the handout Slow weight gain after the first few months for other reasons your milk supply might have decreased and fix the problem if possible.  Most common, probably, frequent use of bottles, but there are others.  Use the Protocol to increase breastmilk intake by the baby.  I much prefer domperidone.  It's safer and it works better because you can use it for long periods of time.
13:06:57 JackNewman Again, those handouts are at the previously posted websites.
13:07:17 lolarose2223 No bottles ever used
13:07:35 Webmama_Tina transcripts will be posted so those of you wanting all this info can read it again after sunday, when i post transcripts :)
13:07:39 JackNewman That's only one of the reasons.  See the handout.
13:07:41 lolarose2223 he nurses all night long
13:07:59 lolarose2223 every hour on the hour
13:08:12 lolarose2223 and only weighs 18lbs
13:08:22 lolarose2223 thanks for your time
13:08:34 lolarose2223 i'll look at the websites
13:08:58 JackNewman The length of time a baby is on the breast is not a measure of how much he is getting.  A baby who breastfeeds well, can nurse 6 times a day and get more than a baby who nurses 24 times a day poorly.  18 pounds at 10 months is not so bad.  Give him more food, use the Protocol.  Try domperidone.
13:09:43 MOD_Angie upcoming chatter(s): mishiemumma, PrincessCass, amica, debbiej74, Tziona
13:09:46 mishiemumma Hello from Michigan! My baby is due 10/12/05, and I am a first time mom. I am getting conflicting advice re: switching breasts. If I end with my left breast, which breast should I start with at my next feeding?
13:10:37 JackNewman Why not do what women all over the world do?  They put their hands on their breasts, feel which is fuller, and give the baby the fuller breast.  See the websites.  It would do you a lot of good to watch the video clips.
13:10:49 mishiemumma How do I know when my breasts are empty?
13:10:53 Pauline ?
13:11:02 Webmama_Tina At this time, the queue is full. Questions already in line will be asked, but we cannot take anymore today. Sorry for the inconvenience.
13:11:37 JackNewman The breast is never empty.  But the baby may not be getting milk anymore.  See the video clips, how to know a baby is getting milk is shown very clearly there.  So when the baby only nibbles, he is not getting milk anymore.  Even if you still have milk in the breast.
13:11:51 mishiemumma What are your views on elimination diets for infant food alergies?
13:12:52 JackNewman The question of allergies is very complex.  Nobody knows how to avoid them.  Breastfeeding helps, but it's not a guarantee.  In fact, many allergists are now suggesting that the way to decrease the risk of allergies is not to avoid allergens, but to be exposed to them.
13:13:21 jpatenaude My gynecologist said that she usually does not do breast exams on lactating moms.  My mom survived breast cancer this summer, and I would like to get a check up soon.  Its been about 2 months since my 3.5 year old nursed regularly.  Can I have a valid exam
13:13:22 mishiemumma Thank you. I'm done. God bless you Dr. Newman.
13:14:03 MOD_Angie upcoming chatter(s): PrincessCass, amica, debbiej74, Tziona
13:14:19 Webmama_Tina jpatenaude there is a line of mamas waiting to ask a question
13:14:23 JackNewman Of course.  Any doctor worth his/her salt can examen a breast, lactating or not.  And ultrasounds, mammography can also be done.  You can have it done even if he were still nursing.
13:14:27 Webmama_Tina and unfortunately, the line is now closed
13:14:40 Webmama_Tina the good doctor is staying into overtime to finish up those in line. :)
13:14:48 PrincessCass My newborn is currently two weeks old she was 7#1oz at birth and at one week had dropped to 6#6oz at two weeks she is still 6#6oz although she has grown an inch
13:14:59 PrincessCass is there a way I can fattin her up
13:15:41 PrincessCass she is exclusivley breastfed
13:16:06 JackNewman Don't let the scale worry you.  Scales are often wrong.  The only way to know if a baby is breastfeeding well is for someone who knows what they are doing to watch the baby at the breast, something a doctor hardly ever does.  So, again, go to the websites, see the Protocol to increase breastmilk intake by the baby, using the video clips to help you.  And get some help from someone who knows what they are doing.
13:16:41 PrincessCass thank you
13:16:44 MOD_Angie upcoming chatter(s):   amica, debbiej74, Tziona
13:17:02 JackNewman That is: fix the latch, know how to know the baby is drinking, use compression to continue the flow of milk, when that doesn't work any more, switch sides and repeat.  Take blessed thistle and fenugreek.  Get good help.
13:18:08 JackNewman Amica, il suo torno.
13:18:16 amica My question is also similar, I've had to supplement due to consecutive weight drops.  I would like to decrease the amt of formula and increase the breastmilk.  If a lactaion aid is necessary, what are your thoughts on fenugreek and blessed thistle?
13:18:31 Webmama_Tina lol
13:18:39 Webmama_Tina you got the hang of this, lol
13:19:08 JackNewman They work quite well, especially in the first few weeks, but after the first few weeks, domperidone works better.  Again, the Protocol to increase breastmilk intake by the baby.
13:19:25 JackNewman Grazie.
13:19:36 amica thanks
13:19:42 Webmama_Tina ok debbie's up!
13:19:43 debbiej74 I am a BFAR mom.  With the help of domperidone, I was able to provide 50% MM to my son.  Given the FDA's current ban on DPD for BFing use in the US, what are the alternatives?  I know there are herbs, but... (sorry if this has been asked, I jumped in late)
13:19:46 MOD_Angie upcoming chatter(s): debbiej74, Tziona
13:20:08 debbiej74 I was able to nurse for 20 months with the help of dpd and the LA, but now I'm worried about what will happen when I have #2
13:20:32 debbiej74 I know one BFAR mom had her shipment of dpd from NZ seized at the border.
13:21:06 Marina lol
13:21:42 Marina but it can be bought over the counter? (here at least)
13:21:56 JackNewman You can still get domperidone in the US with a doctor's prescription at some compounding pharmacies (that are not regulated by the FDA).  Or you can get them over the net.  See www.asklenore.com for how to do that.  There is also a pharmacy in Wisconsin that provides it, 608 835 3191.  It's a good thing the FDA is keeping us safe from domperidone.  And letting in all that heroine.
13:21:57 debbiej74 Dpd is an RX in the US
13:22:10 debbiej74 lol
13:22:28 JackNewman In Canada too.  But it is over the counter in the UK and some other countries (Mexico).
13:22:33 debbiej74 But if I cannot get it, I am worried about what little milk I might produce.
13:22:46 debbiej74 the next time I have a child
13:22:56 JackNewman Very little is seized at the border.  And there are pharmacies like the one in Wisconsin that will provide it.
13:23:13 debbiej74 Hmm..I will have to find that pharmacy as I'm in IL and it would be easy to get it then.
13:23:16 JackNewman There are probably lots more, but that's the only one I have a phone number for.
13:23:22 debbiej74 What is the max dose you recommend?
13:23:37 JackNewman I sent the phone number.  There are probably plenty in Illinois that also provide it.
13:24:06 debbiej74 Or maybe I'll take my luck with NZ again.  That's where I got it all last time.
13:24:08 JackNewman We go as high as 40 mg 4 times a day.  We usually start with 30 mg 3 times a day.  Handouts are available at the previous websites.
13:24:28 debbiej74 Okay, so 160 mg a day is not too much?  Diana West is starting to back down from that number.
13:24:49 JackNewman I'm sure I don't know why she is.  We have had no trouble with it.
13:25:12 debbiej74 Great.  Thanks so much.  I know you have helped countless BFAR moms and we thank you for that.  Next!
13:25:22 Webmama_Tina ok last mama!
13:25:28 Webmama_Tina tziona
13:25:29 Webmama_Tina you're up!
13:25:40 Tziona My daughter is 189 months old and still nursing every 2 hours at night?
13:25:53 Tziona Is there a nutritional reason or is it mainly for comfort?
13:25:59 Tziona sorry 18 months
13:26:07 Webmama_Tina lol
13:26:53 JackNewman It is probably mostly for comfort.  Don't worry she won't always do that.  I'll bet she's charming during the day.  All babies that wake during the night are.  You will survive, though you may not think so now.  See the chapter on sleep in my book.
13:27:07 Tziona she is WONDERFUL during the day
13:27:19 JackNewman You see, I'm not surprised.
13:27:21 Tziona no one believes me that she is so high needs at night
13:27:50 JackNewman High need?  Probably normal need.  Most babies surpress their need because their parents don't respond.
13:28:05 JackNewman You know, let them cry it out.
13:28:07 Tziona is there a nutritional benefit?
13:28:18 Webmama_Tina my screen just went blank...argh
13:28:21 JackNewman It doesn't hurt.  After all, she is drinking some milk.
13:28:22 Tziona my older two were so easy...
13:28:37 Webmama_Tina hope y'all can read me...i'm loggin out and back in again...
13:28:54 Webmama_Tina ok there
13:28:56 JackNewman That's how we define a good" baby.  Sleeps through the night at 3 months.  But that's not necessarily good.  It's not necessarily bad either."
13:29:03 Tziona thank you!
13:29:14 Webmama_Tina sorry about that mamas, my screen went blank...too many PMs i think, lol
13:29:24 Tziona not bad, just harder
13:29:31 Tziona i work full time and its exhausting
13:29:40 JackNewman Yes, but you won't regret it in the long run.
13:29:53 JackNewman All mothers work full time.  Some also have outside jobs.
13:29:54 Webmama_Tina ok so did we get all the questions in the queue then?
13:29:56 Tziona even my good babies woke up at night...and still do!
13:30:05 Marina hahaha that's a good one
13:30:07 Webmama_Tina all babies are good. :)
13:30:18 JackNewman We agree.
13:30:28 Tziona I'm a former Torontonian and I have friends who have seen you for consultation
13:30:38 JackNewman Hope I was able to help.
13:30:44 Webmama_Tina ok, thankyou SOOOOO much dr newman...especially for staying overtime!
13:30:49 Tziona YOU WERE!
13:30:49 Webmama_Tina transcripts will be up on sunday
13:30:59 JackNewman My pleasure.
13:31:00 Webmama_Tina join the egroup to get the announcement...
13:31:03 Webmama_Tina Please join the Mommy Chats egroup at http://groups.yahoo.com/group/mommychats  to receive notices about upcoming chats and changes to Mommy Chats.
13:31:04 Tziona Toronto women are lucky to have you as a local resource
13:31:13 Webmama_Tina Please visit Mommy Chats sponsors by clicking on the ad banners you see above and below this chat and throughout this site. Links will open in a new window.
13:31:16 Webmama_Tina Please visit the Mommy Biz Directory" by clicking on "Mommy Biz's" in the navigation bar at the top and bottom of every Mommy Chats page. (Right click and choose "open in new window" so you don't have to leave this chatroom.)"
13:31:20 JackNewman Thank you for that.  Good to meet" you all.  Bye."

 

 

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