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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