a review of 2006–2007 - breastfeeding outlook · a review of. 2006–2007. simplifying...

A Review of 2006–2007

Simplifying Breastfeeding Management Series

by Marie Biancuzzo, rn Ms iBclc

A Self-Learning Package

Download version

WMC WorldwidePublishing, Educating, Consulting

Professional resources to simplify breastfeeding management...WMC Worldwide, the proud parent of Breastfeeding Outlook, publishes the Breastfeeding Outlook newsletter and a variety of resources to support breastfeeding management and lactation exam preparation, including self-learning packages, flash cards, and parent handouts.

WMC Worldwide also sponsors continuing education programs and provides the consultation services of Marie Biancuzzo, RN MS IBCLC.

A note to the reader:The author and publisher have made every attempt to check content for accuracy. Because the health care sciences are continually advancing, our knowledge base continues to expand. Therefore, we recommend that the reader check product information for changes in dosages, contraindications, and other information before administering any medication or intervention.

A request to the reader:We invite your comments and constructive suggestions. If you find an error, please notify us at [email protected] as soon as possible. Please visit www.breastfeedingoutlook.com for updates and corrections.

Copyright © 2008 by WMC Worldwide, L.L.C.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means without prior written permission of the publisher.

WMC Worldwide, L.L.C.PO Box 387Herndon VA 20172www.breastfeedingoutlook.com

ISBN 978-1-931048-20-0

Download version without newsletters

by Marie Biancuzzo, rn Ms iBclc

A Self-Learning Package

Breastfeeding Outlook:A Review of 2006–2007

Simplifying Breastfeeding Management Series


About Marie

Marie Biancuzzo is the author of the best-selling book, Breastfeeding the Newborn: Clinical Strategies for Nurses. The first editor of AWHONN Lifelines and current editor of Breastfeeding Outlook, Marie has written several self-learning packages and more than 100 articles, many published in peer-reviewed journals. A founding member of the United States Breastfeeding Committee, she is currently President of Baby-Friendly USA.

Marie has first-hand clinical experience with breastfeeding management. In more than two decades of practice, she has held positions as staff nurse, clinical nurse specialist, and nurse administrator at community and university-based hospitals. Formerly the breastfeeding and lactation coordinator for the University of Rochester Medical Center in Rochester, NY, Marie has practiced per diem as a staff nurse in nearly all sub-specialties of maternal/child health.

Marie is also an experienced educator. She has held faculty appointments at the University of Rochester School of Nursing and at Georgetown University School of Nursing. Marie has been certified by the American Nurses Association as a continuing education specialist and completed special training in testing procedures. In addition, she was chosen to serve on the National Council Licensure Examination (NCLEX) panel to develop the RN licensing exam twice. In Marie Biancuzzo’s Lactation Exam Review and other seminars, she has taught thousands of novices and experts across the United States.

In more than 20 years of nursing, writing and speaking, Marie has consistently earned praise for her knowledge, warmth, enthusiasm, and interactive teaching style.

1


Preface

I have always enjoyed the opportunity to browse the latest medical journals, checking the tables of contents and flipping the pages to read the latest research. Unfortunately, I don’t always have time to do so.

And, while I’m greatly interested in the latest breastfeeding-related news—laws proposed and passed, new technology and products, media coverage, pop culture references, etc.—it can be hard to find time for that, too.

Do you know what I mean? Does your daily practice keep you hopping? Do you sometimes feel like you’ve been too busy to keep up with the outside world? Are you looking for an update before taking your IBLCE exam?

When I started Breastfeeding Outlook (then known as Breastfeeding Today) back in 1999, it was to address just such concerns. I wanted this newsletter to help breastfeeding professionals stay up-to-date on the exciting, thought-provoking “stuff” of the field. I wanted to provide information about the latest research that should be the core of solid, evidence-based clinical practice. I wanted to assist exam candidates in brushing up on the new stuff that the IBLCE loves to include on the exam.

I think you’ll find the stories in the newsletter’s back issues as informative today as they were when they first hit the printed page. You’ll see “hot topics,” from obesity to alcohol, pacifiers to gastric bypass surgery. You’ll see coverage of the AAP’s statements, the ABM’s protocols, and the WHO’s guidelines. Above all, I hope you’ll refresh and deepen your understanding of these important issues in ways that may inform your clinical practice, help you pass the exam, or simply earn desired continuing education credits.

Finally, a quick request. This self-learning package looks back at those topics Breastfeeding Outlook has covered over the last few years. If there’s a topic you’d like to suggest we cover in an upcoming issue, feel free to drop us a line at [email protected]. We’re always happy to hear your feedback.

2


Breastfeeding Outlook Index, 2006

Issue 1�•��Can�Breastfeeding�

Mothers Eat Peanuts?•��Don’t�Mention�It!�

[editorial]•��Reasons�Women�Say�They�

Stop Breastfeeding•��Lactation�Counseling�

Does Not Stress NICU Mothers

•��I’m�Made�of�Mama’s�Milk�[media review]

•��Bestfeeding:�How�to�Breastfeed Your Baby, 3rd ed. [media review]

•��The�National�Front•��Recently�Seen•��Professional�Library•��What�Parents�Are�Reading•��Did�You�Know?

Issue 3�•��Can�Women�with�Pierced�

Nipples Breastfeed?�•��It’s�Time�to�be�Heard!�

Shout Out – Not Shut Up [editorial]

�•��Childhood�Bed-wetting�Less Likely for Breastfed Infants

�•��Stop�the�Presses!�Study�Says Breastfeeding and Intelligence Not Linked

�•��Breastfed�Children�Have�Less Stress About Divorce

�•��Mother�of�7�Birth�and�Breastfeeding Series [media review]

�•��Near�Mama’s�Heart�[media�review]

�•��The�National�Front�•��Recently�Seen�•��Professional�Library�•��What�Parents�are�Reading�•��Did�You�Know?

Issue 2�•��New�WHO�Child�Growth�

Standards�•��Follow�the�Money�

[editorial]�•��Oxytocin�Has�No�Effect�

on Early Postpartum Milk Supply

�•��Maternal�Depression�Affects�Early Parenting Practices

�•��Breastfeeding�Patterns�and�Milk Volume Varies Greatly Among Mother-Infant Dyads

�•��Depression�in�New�Mothers:�Causes,�Consequences and Treatment Alternatives [media review]

�•��The�National�Front�•��Recently�Seen�•��Professional�Library�•��What�Parents�Are�Reading�•��Did�You�Know?

Issue 4�•��Formula:�From�Start�to�

Finish, It’s Bad News•�Got�Ethics?�[editorial]•��Are�Breastfeeding�

Initiation, Cessation Linked to Partner Violence?

•��Study�Looks�at�Link�between Employment, Breastfeeding

•��Nasal�S. aureus in Infants May Lead to Mastitis in Mothers

•��First�Year�Milestones:�A�Monthly Guide to Your Baby’s Growth [media review]

•��The�National�Front•��Recently�Seen•��Professional�Library•��What�Parents�Are�Reading•��New�Product�

Announcements�•��Did�You�Know?

3


Issue 1��•��MRSA and the

Breastfeeding Dyad��•��Father�Knows�Best?�

[editorial]��•��Breastfeeding May Protect

Against Developmental Delays

��•��Public Attitudes about Breastfeeding Less Favorable

��•��The Benefits of Bedsharing [media review]

��•��Mothers�and�Medicine:�A�Social History of Infant Feeding 1890-1950 [media review]

��•��The National Front��•��Recently Seen��•��Professional Library��•��What Parents Are Reading�•��Did�You�Know?

Issue 2�•��The�Nose�Knows:�Lipase�

in Mother’s Milk�•��Depo and the God-

Doctors [editorial]�•��Perchlorate�and�Iodine:�

What It All Means�•��Flash Heat Inactivation

for HIV�•��Sleeping�with�Your�Baby:�

A Parent’s Guide to Cosleeping [media review]

�•��Breastfeeding:�Your�Priceless Gift to Your Baby and Yourself [media review]

�•��The National Front�•��Recently Seen�•��Professional Library�•��What Parents Are Reading�•��You Asked?�•��Did�You�Know?

Issue 3�•��Mother’s Milk. What

Container for Storage and Feeding?

�•��The Humble Olive [editorial]

�•��Breastfeeding After Breast Reduction

�•��Nursing Mother, Working Mother:�The�Essential�Guide to Breastfeeding Your Baby Before and After Your Return to Work [media review]

�•��Mama’s Milk [media review]

�•��The National Front�•��Recently Seen�•��Professional Library�•��What Parents Are Reading�•��Did�You�Know?

Issue 4�•��Helping Mothers Choose

Milk Storage Bags�•��The Original Fast Food

[editorial]�•��Breastfeeding Duration,

Cancer Risk Linked�•��Breastfeeding Reduces

Severity of Sleep Disordered Breathing

�•��Nursing Mother’s Guide to Weaning [media review]

�•��The National Front�•��Recently Seen�•��Professional Library�•��What Parents Are Reading�•��Quick Quiz�•��Did�You�Know?

Breastfeeding Outlook Index, 2007

4


Goals and Objectives

Goal: To help professionals update their clinical breastfeeding and lactation management through a structured review of recent research studies.

Objectives: Using selected research studies and other media published in 2006 and 2007, the participant will�be�able�to:

� •�describe�how�study�results�can�influence�breastfeeding�and�lactation�management.�

� •�counsel�mothers�appropriately,�based�on�emerging�societal�issues�and�trends.�

� •��describe�new�technologies�that�support�breastfeeding�in�terms�of�their�indications,�advantages,�disadvantages, and clinical how-to techniques.

� •��describe�new�statements�and�efforts�by�national�and�international�organizations�that�may�drive�changes�in recommendations for lactating mothers and their nurslings.

5


Instructions for Users of this Package

Welcome to the Simplifying Breastfeeding Management Series!We know you’ll want to take advantage of the convenience and affordability of earning contact hours and CERPs�when�you�want,�where�you�want!

The Simplifying Breastfeeding Management series gives nurses, lactation consultants, childbirth educators, and others a great opportunity to earn continuing education credits toward licensure or certification renewal. You’ll appreciate that you pay only for what you need. If you need only the learning package, that’s what you’ll pay for. If you have the package and need the continuing education credits, that’s what you’ll pay for. If colleagues borrow your package and want the continuing education credits, that’s�all�they�pay�for!

We’ve�enclosed�materials�so�that�you�can�start�earning�credits�right�away!�It’s�easy!�Just�complete�the�steps�below and submit the required forms with payment, and you’ll be on your way to earning credits.

1. Track the time it takes you to complete this self-learning package. Include time for reading the information, doing the learning activities, and completing the pre- and post-tests.

2. Complete the 10-question true/false pre-test.

3. Read the Breastfeeding Outlook newsletter issues for 2006 and 2007. If you don’t have the back issues, you can order them from www.breastfeedingoutlook.com or with the Order Form at the end of this package.

4. Complete the post-test (pages 17–20) on your own, without assistance from anyone else. Write your answers on the answer sheet (page 21.) Copies of the post-test and answer sheet are available at the end of this package or on our web site at www.breastfeedingoutlook.com

5. Answer all questions carefully. Remember that payment is for the opportunity to earn credits, and it will not be refunded if you do not pass the post-test.

6. Complete the evaluation of the package found on pages 23–24. Copies of the evaluation form are also available on our web site at www.breastfeedingoutlook.com

7. Enclose payment. We accept checks drawn on US banks, as well as Visa, Mastercard, American Express, and Discover. Payment details are on the answer sheet.

8. Mail the answer sheet, evaluation form and payment to:

Breastfeeding Outlook, Dept. CE PO Box 387 Herndon VA 20172-0387

Or, if paying by credit card, fax to: 703-787-9895

Please allow up to 2 weeks for a response to your application for continuing education recognition. We�hope�you�find�this�a�great�learning�experience!

Continuing Education Approval

Approved for 4.2 contact hours.

Approved for 4.2 L-CERPs.

Note: Occasionally, the number or availability of contact hours may change. Check www.breastfeedingoutlook.com for updates.

6


Frequently Asked Questions

Q: Where do I send my completed post-test?A:�� Mail�your�post-test�and�other�materials�to�us�here�at�Breastfeeding�Outlook,�Dept.�CE,�PO�Box�387,�

Herndon VA 20172-0387 or fax to 703-787-9895. Please do not send your materials to your certifying or�licensing�agency;�they�are�not�involved�in�the�preparation�or�processing�of�your�post-test!

Q: Can I submit the post-test any time?A:� �It�is�a�good�idea�to�complete�the�post-test�as�soon�as�you�can�after�you�receive�your�self-learning�

package, since the certifying agencies do occasionally change the rules about how providers calculate credit hours; if that happens the number or availability of contact hours awarded for this package may change.

Q: Can I do the entire self-learning program at home?A:� Yes!�

Q: Other organizations charge an additional $25 fee to people who use borrowed booklets to earn continuing education recognition. How much extra do you charge?

A:� �We�charge�no�additional�fee!�Someone�using�a�borrowed�self-learning�package�will�pay�the�same�amount as anyone else applying for credits.

Q: I would like to get both nursing contact hours and CERPs. Is there an additional fee to get credit for both?

A:� �No.�Your�Certificate�of�Achievement�will�show�approval�from�multiple�certifying�bodies.�The�fee�that�you pay will cover it all.

Q: How well do I have to do to pass the post-test?A:� The�passing�level�is�80%.

Q: How and when will I find out my score?A:� �We�will�send�both�our�response�and�your�results�no�later�than�two�weeks�from�when�we�receive�your�

completed post-test. Sometimes, we are able to send a response even sooner.

Q: If I fail the test, how much will I have to pay to take it again?A:� You’ll�only�have�to�pay�a�$10�processing�fee.�

Q: How can I find out about updates or modifications to the package? A:� �Check�our�web�site�at�www.breastfeedingoutlook.com�for�information.�Updates�and�other�

modifications will be listed there.

Q: Can I contact you if I have questions or comments?A:� �Yes,�please�do!�We�like�to�hear�from�people�who�purchase�our�publications.�E-mail�us�at�

[email protected] or write to us at Breastfeeding Outlook, PO Box 387, Herndon VA 20172-0387. We discourage phone calls, which tend to be more time-consuming for our staff and would eventually force us to raise our publication prices.

Q: I really enjoyed the self-learning package. Do you publish others? A:� �Yes!�We�have�several�packages�already�available�and�new�ones�are�always�in�development.�Visit�our�web�

site�at�www.breastfeedingoutlook.com�to�see�what’s�new!

7


Pre-test

Please�answer�the�following�questions�as�true�or�false:

t f 1. A child’s peanut allergy is predicted more by the presence of allergy in siblings than the absence of allergy in parents.

t f 2. New growth standards developed by the World Health Organization show how children “do” grow, rather than how they “should” grow.

t f 3. Even mothers who have allowed their nipple piercings to close may be at increased risk of mastitis.

t f 4. Children in urban areas are more likely than their rural peers to be breastfed for six months.

t f 5. A MRSA-positive mother who is home and otherwise well may safely breastfeed her healthy, term baby.

t f 6. To inactive lipase in her milk, a mother should boil the milk for sixty seconds.

t f 7. Even infants who receive their mother’s milk at the breast will react negatively to high-lipase milk.

t f 8. The only safe storage container for mother’s milk is a glass bottle.

t f 9. A diagnosis of colic negatively affects duration of full, but not exclusive or partial breastfeeding.

t f 10. Breastfeeding protects against breast cancer for premenopausal, but not postmenopausal women.

Answers can be found on page 13.

8


References

Enterobacter sakazakii infections associated with the use of powdered infant formula—Tennessee, 2001. MMWR.�2002;51:298-300.

Mom�of�baby�poisoned�by�alcohol�claims�accident.�Available�at�http://www.krdo.com

American Academy of Pediatrics. Committee on Nutrition. Hypoallergenic infant formulas. Pediatrics. August�2000;�106�(2�Pt�1):�346–349.

AAP Committee on Nutrition. New infant formula additives approved by FDA. AAP News.�2002;20:209.

AAP Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics.�2005;115:496-506.

Ahluwalia�IB,�Morrow�B,�Hsia�J.�Why�do�women�stop�breastfeeding?:�Findings�from�the�Pregnancy�Risk�Assessment and Monitoring System. Pediatrics.�2005;116:1408–1412.

Al-Muhsen�S,�Clarke�AE,�Kagan�RS.�Peanut�allergy:�An�overview.�CMAJ.�2003;168(10):1279–1285.

Amir�L.�Breastfeeding�and�Staphylococcus�aureus:�Three�case�reports.�Breastfeed Rev.�2002;10(1):15-18.

Amir�LH,�Garland�SM,�Lumley�J.�A�case-control�study�of�mastitis:�Nasal�carriage�of�Staphylococcus�aureus. BMC Fam Pract.�2006;7(57).:1-9.

Anderson�SA,�Chinn�HI,�Fisher�KD.�History�and�current�status�of�infant�formulas.�Am J Clin Nutr. 1982;35:381-397.

Ball TM, Bennett DM. The economic impact of breastfeeding. Pediatr Clin North Am.�2001;48(1):253-262.

Barone�JG,�Ramasamy�R,�Farkas�A,�Lerner�E,�Creenan�E,�Salmon�D.�Breastfeeding�during�infancy�may�protect against bed-wetting during childhood. Pediatrics.�2006;118(1):254-259.

Behari�P,�Englund�J,�Alcasid�G,�Garcia-Houchins�S,�Weber�SG.�Transmission�of�methicillin-resistant�Staphylococcus aureus to preterm infants through breast milk. Infect Control Hosp Epidemiol. 2004;25(9):778-780.

Bessey�O,�Adam�DJD,�Hansen�AE.�Intake�of�vitamin�B6�and�infantile�convulsions:�A�first�approximation�of pyridoxine in infants. Pediatrics.�1957;20:33-44.

Biancuzzo M. Ask the expert. Breastfeeding Outlook.�2005;(4):6.

Biancuzzo M. What Every Parent Needs to Know About Pierced Nipples and Breastfeeding. [parent handout] Herndon,�VA:�Breastfeeding�Outlook,�2006.

Bowen AB, Braden CR. Invasive Enterobacter sakazakii disease in infants. Emerg Infect Dis. 2006;12:1185-1189.

Cassidy�A,�Bingham�S,�Setchell�KD.�Biological�effects�of�a�diet�of�soy�protein�rich�in�isoflavones�on�the�menstrual cycle of premenopausal women. Am J Clin Nutr. 1994;60:333-340.

Castillo M, Sanjuán A, Pérez N, et al. Fibrous histiocytomalike spindle-cell proliferation in the nipple after body-piercing. Int J Surg Pathol.�2006;14(1):89-93.

Center for the Evaluation of Risks to Human Reproduction. Report on the Reproductive and Developmental�Toxicity�of�Bisphenol�A.�2007.�Available�at: http://cerhr.niehs.nih.gov/chemicals/bisphenol/BPA_Interim_DraftRpt.pdf

9


Cruz�NL,�Korchin�L.�Lactational�performance�after�breast�reduction�with�different�pedicles.�Plast Reconstr Surg.�2007;120:35-40.

Dee DL, Li R, Lee LC, Grummer-Strawn LM. Associations between breastfeeding practices and young children’s language and motor skill development. Pediatrics.�2007(119):�S92-S98.

de Onis M, Onyango AW. The Centers for Disease Control and Prevention 2000 growth charts and the growth of breastfed infants. Acta Paediatr. 2003;92(4):413-419.

Dupuy�P,�Sauniere�JF,�Vis�HL,�Leclaire�M,�Lombardo�D.�Change�in�bile�salt�dependent�lipase�in�human�breast milk during extended lactation. Lipids.�1991;26(2):134-138.

Eglin RP, Wilkinson AR. HIV infection and pasteurisation of breast milk [letter]. Lancet. 1987;1(8541):1093.

Fein SB, Falci CD. Infant formula preparation, handling, and related practices in the United States. J Am Diet Assoc.�1999;99:1234-1240.

Ferguson H. Body piercing. BMJ.�1999;319(7225):1627-1629.

Fewtrell�MS,�Loh�KL,�Blake�A,�Ridout�DA,�Hawdon�J.�Randomised,�double�blind�trial�of�oxytocin�nasal spray in mothers expressing breast milk for preterm infants. Arch Dis Child Fetal Neonatal Ed. 2006;91(3):F169-174.

Forsythe�SJ.�Enterobacter�sakazakii�and�other�bacteria�in�powdered�infant�milk�formula.�Matern Child Nutr. 2005;1:44-50.

Freed�LM,�Berkow�SE,�Hamosh�P,�Yo.�Lk�CM,�Mehta�NR,�Hamosh�M.�Lipases�in�human�milk:�Effect�of�gestational age and length of lactation on enzyme activity. J Am Coll Nutr. 1989;8(2):143-150.

Garza�C,�Johnson�CA,�Harrist�R,�Nichols�BL.�Effects�of�methods�of�collection�and�storage�on�nutrients�in�human milk. Early Hum Dev.�1982;6(3):295-303.

Gastelum DT, Dassey D, Mascola L, Yasuda LM. Transmission of community-associated methicillin-resistant Staphylococcus aureus from breast milk in the neonatal intensive care unit. Pediatr Infect Dis J. 2005;24(12):1122-1124.

Gerrard�JW,�Perelmutter�L.�IgE-mediated�allergy�to�peanut,�cow’s�milk,�and�egg�in�children�with�special�reference to maternal diet. Ann Allergy. 1986;56(4):351-4.

Goldblum RM, Dill CW, Albrecht TB, Alford ES, Garza C, Goldman AS. Rapid high-temperature treatment of human milk. J Pediatr.�1984;104:380-384.

Gumus B, Vurgun N, Lekili M, Iscan A, Muezzinoglu T, Buyuksu C. Prevalence of nocturnal enuresis and accompanying factors in children aged 7-11 years in Turkey. Acta Paediatr.�1999;88(12):1369-1372.

Hamosh M. Protective function of proteins and lipids in human milk. Biol Neonate.�1998;74(2):163-176.

Hamosh M. Lipid metabolism in pediatric nutrition. Pediatr Clin North Am.�1995;�42(4):839-859.

Harder�T,�Bergmann�R,�Kallischnigg�G,�Plagemann�A.�Duration�of�breastfeeding�and�risk�of�overweight:�A meta-analysis. Am J Epidemiol.�2005;162(5):397-403.

Hawkins NM, Coffey S, Lawson MS, Delves HT. Potential aluminum toxicity in infants fed special infant formula. J Pediatr Gastroenterol Nutr.�1994;19:377-381.

Holick MF, Shao Q, Liu WW, Chen TC. The vitamin D content of fortified milk and infant formula. N Engl J Med.�1992;326:1178-1181.

10


Hourihane�JO,�Dean�TP,�Warner�JO.�Peanut�allergy�in�relation�to�heredity,�maternal�diet,�and�other�atopic�diseases:�Results�of�a�questionnaire�survey,�skin�prick�testing,�and�food�challenges.�BMJ. 1996;313 (7056):�518–521.

Howard CR, Lanphear N, Lanphear BP, Eberly S, Lawrence RA. Parental responses to infant crying and colic:�The�effect�on�breastfeeding�duration.�Breastfeed Med. 2006;1:146-155.

Israel-Ballard�K,�Donocan�R,�Chantry�C,�Coutsoudis�A,�Shepphard�H,�Sibeko�L,�et�al.�Flash-heat�inactivation�of�HIV-1�in�human�milk:�A�potential�method�to�reduce�postnatal�transmission�in�developing�countries. J Acquir Immune Defic Syndr.�Jul�1�2007;45(3):318-323.

Jacobs�VR,�Golombeck�K,�Jonat�W,�Kiechle�M.�Mastitis�nonpuerperalis�after�nipple�piercing:�Time�to�act.�Int J Fertil.�2003;48(5):226-231.

Kawada�M,�Okuzumi�K,�Hitomi�S,�Sugishita�C.�Transmission�of�Staphylococcus�aureus�between�healthy,�lactating mothers and their infants by breastfeeding. J Hum Lact.�2003;19(4):411-417.

Kent�JC,�Mitoulas�LR,�Cregan�MD,�Ramsay�DT,�Doherty�DA,�Hartmann�PE.�Volume�and�frequency�of�breastfeedings and fat content of breast milk throughout the day. Pediatrics.�2006;117(3):e387-395.

Kitajima�H.�Prevention�of�methicillin-resistant�Staphylococcus�aureus�infections�in�neonates. Pediatr Int. 2003;45(2):238-245.

Lawrence RA. Storage of human milk and the influence of procedures on immunological components of human milk. Acta Paediatr Suppl. Aug�1999;88(430):14-18.

Lawrence�RA,�Lawrence�R.�M.�Breastfeeding:�A�Guide�for�the�Medical�Profession.�6�ed.�St.�Louis:�Mosby;�2005.

Lewis�CG,�Wells�MK,�Jennings�WC.�Mycobacterium�fortuitum�breast�infection�following�nipple-piercing, mimicking carcinoma. Breast J.�2004;10(4):363-365.

Li�R,�Rock�VJ,�Grummer-Strawn�L.�Changes�in�public�attitudes�toward�breastfeeding�in�the�United�States, 1999-2003. J Am Diet Assoc.�2007;107:122-127.

Malloy MH. The follow-up of infants exposed to chloride-deficient formulas. Adv Pediatr. 1993;40:141-158.

Martin�J.�Is�nipple�piercing�compatible�with�breastfeeding?�J Hum Lact.�2004;20(3):319-321.

McJunkin�JE,�Bithoney�WG,�McCormick�MC.�Errors�in�formula�concentration�in�an�outpatient�population. J Pediatr. 1987;111:848-850.

McLearn�KT,�Minkovitz�CS,�Strobino�DM,�Marks�E,�Hou�W.�Maternal�depressive�symptoms�at�2�to�4�months post partum and early parenting practices. Arch Pediatr Adolesc Med.�Mar�2006;160(3):279-284.

Meltzer DI. Complications of body piercing. Am Fam Physician.�2005;72(10):2029-2036.

Mennella�JA,�Beauchamp�GK.�The�effects�of�repeated�exposure�to�garlic-flavored�milk�on�the�nursling's�behavior. Pediatr Res.�1993;34(6):805-808.

Moneret-Vautrin�DA,�Hatahet�R,�Kanny�G.�Risks�of�milk�formulas�containing�peanut�oil�contaminated�with peanut allergens in infants with atopic dermatitis. Pediatr Allergy Immunol.�August�1994;�5(3):�184–188.

Montgomery SM, Ehlin A, Sacker A. Breast feeding and resilience against psychosocial stress. Arch Dis Child. 2006; Epub.

11


Montgomery-Downs HE, Crabtree VM, Capdevilla OS, Gozal D. Infant-feeding methods and childhood sleep-disordered breathing. Pediatrics.�2007;120:1030-1035.

Neville�MC,�Waxman�LJ,�Jensen�D,�Eckel�DH.�Lipoprotein�lipase�in�human�milk:�Compartmentalization�and effect of fasting, insulin, and glucose. J Lipid Res. 1991;32(2):251-257.

Novak FR, DaSilva AV, Hagler AN, Figueredo AM. Contamination of expressed human breast milk with an epidemic multiresistant Staphylococcus aureus clone. J Med Microbiol. 2000;49(12):1109-1117.

Novak�FR,�Almeida�JA,�Warnken�MB,�Ferreira-Carvalho�BT,�Hagler�AN.�Methicillin-resistant�Staphylococcus aureus in human milk. Mem Inst Oswaldo Cruz. 2000;95(1):29-33.

Office�on�Women's�Health.�HHS Blueprint for Action on Breastfeeding. Washington�DC:�US�Department�of Health and Human Services, 2000.

Olivecrona T, Hernell O. Human milk lipases and their possible role in fat digestion. Padiatr Padol. 1976;11(4):600-604.

Orloff�SL,�Wallingford�JC,�McDougal�JS.�Inactivation�of�human�immunodeficiency�virus�type�I�in�human�milk:�Effects�of�intrinsic�factors�in�human�milk�and�of�pasteurization.�J Hum Lact.�1993;9(1):13-17.

Paxson�CLJ,�Cress�CC.�Survival�of�human�milk�leukocytes.�J Pediatr. 1979;94(1):61-64.

Pearce EN, Leung AM, Blount BC, Bazrafshan HR, He X, Pino S, et al. Breast milk iodine and perchlorate concentrations in lactating Boston-area women. J Clin Endocrinol Metab. 2007;92(5):1673-1677.

Renfrew�MJ,�Ansell�P,�Macleod�KL.�Formula�feed�preparation:�Helping�reduce�the�risks:�A�systematic�review. Arch Dis Child. 2003;88:855-858.

Roy S. Perspectives on adverse effects of milks and infant formulas used in infant feeding. J Am Diet Assoc. 1983;82:373-377.

Ruis H, Rolland R, Doesburg W, Broeders G, Corbey R. Oxytocin enhances onset of lactation among mothers delivering prematurely. Br Med J Clin Res Ed.�1981;283(6287):340-342.

Ryan AS, Zhou W, Arensberg MB. The effect of employment status on breastfeeding in the United States. Women’s Health Issues.�2006;16:243-251.

Setchell�KD,�Zimmer-Nechemias�L,�Cai�J,�Heubi�JE.�Isoflavone�content�of�infant�formulas�and�the�metabolic fate of these phytoestrogens in early life. Am J Clin Nutr.�1998;68:1453S-1461S.

Shannon�M,�Graef�JW.�Lead�intoxication�from�lead-contaminated�water�used�to�reconstitute�infant�formula. Clin Pediatr.�1989;28:380-382.

Shema L, Ore L, Ben-Shachar M, Haj M, Linn S. The association between breastfeeding and breastfeeding�occurrence�among�Israeli�Jewish�women:�a�case�control�study.�J Cancer Res Clin. 2007;133:539-546.

Sicherer SH. The impact of maternal diets during breastfeeding on the prevention of food allergy. Curr Opin Allergy Clin Immunol. 2002;�2(3):�207–210.

Silverman�JG,�Decker�MR,�Reed�E,�Raj�A.�Intimate�partner�violence�around�the�time�of�pregnancy:�Association with breastfeeding behavior. J Women’s Health. 2006;15(8):934-940.

Singh�H,�Kaur�L,�Kataria�SP.�Enuresis:�Analysis�of�100�cases.�Indian Pediatr. 1991;28(4):375-380.

12


Sisk�PM,�Lovelady�CA,�Dillard�RG,�Gruber�KJ.�Lactation�counseling�for�mothers�of�very�low�birth�weight�infants:�Effect�on�maternal�anxiety�and�infant�intake�of�human�milk.�Pediatrics.�2006;117:�e67–75.

Slusser�WM,�Lange�L,�Dickson�V,�Hawkes�C,�Cohen�R.�Breast�milk�expression�in�the�workplace:�A�look�at frequency and time. J Hum Lact.�2004;20(2):164-169.

Tal MG. Correction of inverted nipple using piercing. Plast Reconstr Surg.�2003;112(4):1178-1179.

Thompson�J.�Breastfeeding:�Benefits�and�inplications.�Community Pract.�2005;78(5):183-4�and�78(6):218-219.

Trupiano�JK,�Sebek�BA,�Goldfarb�J,�Levy�LR,�Hall�GS,�Procop�GW.�Mastitis�due�to�Mycobacterium�abscessus after body piercing. Clin Infect Dis.�2001;33(1):131-134.

Turoli D, Testolin G, Zanini R, Bellu R. Determination of oxidative status in breast and formula milk. Acta Paediatr. 2004;93(12):1569-1574.

Vadas P, Wai Y, Burks W, Perelman B. Detection of peanut allergens in breast milk of lactating women. JAMA.�2001;�285(13):�1746–1748.

Weimer�J.�The Economic Benefits of Breastfeeding: A Review and Analysis. #13.�Washington�DC:�Economic�Research Service, United States Department of Agriculture, 2001.

WHO�Collaborative�Group�on�Hormonal�Factors�in�Breast�Cancer.�Breast�cancer�and�breastfeeding:�Collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50,302 women with breast cancer and 96,973 women without the disease. Lancet.�2002;360(9328):187-195.

Williamson�MT,�Murti�PK.�Effects�of�storage,�time,�temperature,�and�composition�of�containers�on�biologic components of human milk. J Hum Lact.�1996;12(1):31-35.

Wilson DH, Wilson SM. Peanut allergy. N Engl J Med.�2003;349(3):301–303.

Zardawi�IM,�Jones�F,�Clark�DA,�Holland�J.�Gordonia�terrae-induced�suppurative�granulomatous�mastitis�following nipple piercing. Pathol.�2004;36(3):275-278.

Zeiger RS. Dietary aspects of food allergy prevention in infants and children. J Pediatr Gastroenterol Nutr. 2000;�30�Suppl:S77–86.

13

Answers:�1.�True,�2.�False,�3.�True,�4.�True,�5.�True,�6.�False,�7.�False,�8.�False,�9.�True,�10.�False.


14


15

Be sure to read the 2006 and 2007 issues of

Breastfeeding Outlook before�you�complete�the�post-test!


16


17

Post-test

You may use the learning package to look up answers to the following questions. Write the best answer on the enclosed answer sheet. Please be sure to complete all test items.

1.�Lactation�services�are�not�part�of�the�employee�benefit�primarily�because: a. The Healthy People 2010 goals cannot be quantified in dollar amounts, so employers are leery of

offering such benefits. b. Insurance companies are resistant, because they’ve tried it in the past and have not realized any

cost savings. c. Although commonly categorized as a health benefit, the logistics of providing the service are too

cumbersome. d. Lactation services are commonly categorized as a family-friendly benefit, and then assigned a low

priority.

2. The WHO Child Growth Standards, released in 2006, describe normal growth and development for 8,440 children from birth to age 5. These new growth standards differ from the previous charts because they

a. are based on U.S. children only, so providers can compare their pediatric clients to U.S. peers. b. show how children “should grow” rather than how children “do grow,” and therefore establish a

standard. c. make no distinction between a standard and a reference, which enables providers to better judge

breastfed infants. d. do not establish feeding method as a norm, but instead give charts for both bottle-fed and

breastfed infants.

3.��Fewtrell�and�colleagues�(2006)�conducted�a�study�in�the�UK�that�was�important�to�professionals�involved in breastfeeding management because it was

a. a descriptive study that showed the oxytocin nasal spray helped mothers who could not experience let-down.

b. a qualitative study that confirmed a previous study that oxytocin nasal spray is effective for pump-dependent mothers to achieve let-down.

c. a case-control study that was well-designed, although it was widely misinterpreted in the popular press.

d. a randomized controlled trial which refuted a previous study that showed oxytocin nasal spray improves milk supply.

4. McLearn and colleagues (2006) conducted a descriptive study of families nationwide and found that among�mothers�who�were�depressed�at�2-4�months�postpartum:

a. More than half who reported symptoms of depression quit breastfeeding by 2-4 months. b. Reading books, talking to their babies, and following a routine were not helpful in reducing the

depressive symptoms. c. There was an observable but not significant relationship between postpartum depression and

parenting behaviors. d. Breastfeeding mothers were significantly (p < 0.001) more likely to be depressed, compared to

formula-feeding mothers.

continued on the next page


18

5. A mother calls you and describes several symptoms that seem to warrant medical follow-up for mastitis. Although she reports all of the following, which factor would be LEAST likely to be associated with an episode of mastitis?

a. recent positive culture for staph in the maternal nose. b. recent positive culture of staph in the infant’s nose. c. a recent episode of sore, cracked nipple skin. d. a recent episode of boils or abscesses.

6. Parents you see in your daily practice have made all of the following statements. Which one should you confirm as being true?

a. The Infant Formula Act of 1980 has almost entirely eliminated safety problems with the formulation and manufacturing of infant formula.

b. DHA and ARA were added to formula only after the FDA conducted a thorough investigation of their safety and efficacy.

c. Expired formula has been found in both commercial pharmacies and hospital settings. d. The “dose” of formula given is unlikely to be problematic as long as the parents know how to mix

it correctly.

7. A mother is breastfeeding her 6-week-old infant. The mother has ingested peanuts. The baby’s brother is allergic to peanuts, and the mother is worried that her 6-week-old daughter will have an allergic reaction. Which of the following would be the best response?

� a.� “It’s�certainly�possible,�but�less�than�2%�of�children�have�food�allergies,�so�it’s�unlikely.”�� b. “Is her father allergic to peanuts? If not, you may occasionally eat a small handful of peanuts.” c. “You may want to avoid peanuts for the time being. Do you know what to do in the case of

anaphylactic shock?” d. “Did she have a reaction when you have eaten peanuts previously? Food allergies generally show

up at the first exposure.”

8. A study conducted by Howard and colleagues (2006) found that if the physician diagnosed the infant with colic,

a. the duration of full breastfeeding was shortened. b. the duration of exclusive breastfeeding was shortened. c. both the physician’s diagnosis and the parental report were consistent with the classic Wessel

criteria. d. the parents were more likely to report breastfeeding as a comfort measure.

9. Which of the following statements most accurately reflects what we might tell mothers about storing their milk for their infants?

a. Most authorities agree that a glass bottle is a superior storage container, and is worth the extra expense.

b. Although glass is easier to sterilize, leukocytes stick to the glass and therefore lose their protective properties.

c. Plastic bottles, considered safe until recently, are all contaminated with Bisphenol A and should be avoided.

d. For most healthy infants, the mother may safely store her milk in either glass or plastic containers.



19

10. Based on the results of a recent study by Montgomery-Downs and colleagues (2007), which of the following would you teach parents?

a. Exclusive breastfeeding prevents snoring in general and sleep disordered breathing (SDB) in particular.

b. The risk for SDB is reduced if the infant is breastfed through 5 months, but risk reduction does not increase thereafter.

c. The pathophysiology of SDB can be directly related to the infant’s oral anatomy. d. The respiratory arousal index is lower for infants breastfed through 2 months.

11. Based on the study by Shema and colleagues (2007) which of the following could you tell clients who ask about the relationship between breastfeeding and the development of breast cancer?

a. Longer duration of breastfeeding correlates to lower incidence of cancer among premenopausal but not postmenopausal women.

b. Longer duration of breastfeeding correlates to lower incidence of cancer among postmenopausal but not premenopausal women.

c. Longer duration of breastfeeding correlates to lower incidence of breast cancer among both premenopausal and postmenopausal women.

d. Breastfeeding for longer than one year was related to lower incidence of breast cancer, with the relationship stronger for postmenopausal women.

12. If a mother reports that her milk smells “bad,” which of the following would be the BEST response to her?

a. “The milk should not be given under any circumstances.” b. “Freezing the milk will eliminate the bad smell.” c. “Does it smell more sour or more soapy?” d. “If the baby rejects it, it has been spoiled.”

13. If the mother’s milk has a high level of lipase, you could advise her to a. boil the milk, which will destroy the lipase as well as any bacteria. b. scald the milk to 180° F (about 82° C). c. freeze the milk at about -20° C (-4° F). d. discard the milk, because it is not safe for the baby to consume.

14. Research by Israel-Ballard and colleagues (2007) shows that flash heat a. can be accomplished by having the milk at 100° F. b. can be accomplished by having the milk at 62.5° C. c. results in samples having no detectable HIV (p < 0.00001). � d.�results�in�about�72%�of�the�samples�having�detectable�HIV�(p <.01).

15. Women who ask about the safety of DepoProvera injections during breastfeeding should be told that a. According to the manufacturer’s instructions, women may “have their first injection during or

after their sixth postpartum week.” b. According to the manufacturer’s instructions, women may “have their first injection during or

after the 1st postpartum day.” c. The manufacturer’s instructions are incongruent with the recommendations from Medline Plus, a

highly respected source. d. The manufacturer’s instructions rank Depo as an L1, so it is known as harmless.



20

16. From the recent study by Pearce and colleagues (2007), clinical management of nutrition for infants should�be�carried�out�with�the�understanding�that:

a. High levels of perchlorate are likely to be present in the milk of mothers throughout the United States, and this is dangerous for the infant.

b. Perchlorate levels of 10 ug/L are always predictive of decreased iodine levels in the mother’s milk, which increases the risk for kwashiorkor.

c. Infant formula consistently provides mean iodine concentrations as stated on the labels. d. Here, the levels of mean iodine concentrations in formula differed significantly from levels listed

on the label (p < 0.0001).

17. A HealthStyles questionnaire (Li 2007) conducted in 1999 and again in 2003 asked people about their belief that “infant formula is as good as breastmilk.” The survey found that the number of respondents who believed this

� a.� decreased�by�nearly�37%.�� b.�decreased�by�about�54%.�� c.� increased�by�about�54%.� d.� increased�by�about�79%.

18. The US General Accounting Office data show that the amount of money spent on formula advertising in 2003 was

� a.� $29�million,�about�65%�more�than�in�1999.�� b.�$29�million,�about�65%�less�than�in�1999.� c.� $48�million,�about�65%�more�than�in�1999.� d.�$48�million,�about�65%�less�than�in�1999.�

19.��A�study�by�Kawada�(2003)�showed�that�among�women�who�do�not�have�any�signs�or�symptoms�of�mastitis,

� a.� about�50%�transmitted�MRSA�to�their�breastfeeding�infants.� b.� about�25%�transmitted�MRSA�to�their�breastfeeding�infants. c. The likelihood of MRSA being transmitted via their milk is almost nil. d. MRSA, even if transmitted via mother’s milk, is harmless.

20. In which of the following instances would you be MOST likely to suspect MRSA? a. A mother took doses of dicloxicillin and her symptoms of mastitis did not improve after 12

hours. b. A baby rooming-in at the hospital with his mother, who has a documented case of MRSA. c. The milk a mother pumped at 2 days post-delivery was bright yellow. d. A swab of a mother’s nose shows colonies of S. aureus.


21

Post-test Answer Sheet

Answers to Post-test Statement from Participant

I�have:

o Completed the 10-question true/false pre-test on page 8.

o Read all of the 2006 and 2007 issues of Breastfeeding Outlook.

o Completed the open-book post-test on pages 17–20 without assistance from others.

o Written answers to the post-test in the spaces to the left.

o Completed and returned the evaluation form on pages 23–24.

o Understood that payment is for the opportunity to earn credits and is not refunded if I do not pass the post-test.

o Enclosed my payment.By signing below, I declare that the above statements are true.

Signed �_______________________________________________________________________________________

If�IBCLC,�date�of�certification:��____________________________________________________________________

We will not grade your post-test until you mail or fax all of the following materials: •Packageevaluation •Thissheet,completedandsigned •Paymentfor$25.00(Check,Visa,MasterCard,AmericanExpressorDiscover)to:

BreastfeedingOutlook,Dept.CE POBox387,HerndonVA20172-0387 Fax:703-787-9895

Name�_______________________________________Organization�______________________________________

Address �______________________________________________________________________________________

City, State, ZIP� ________________________________________________________________________________

Phone �___________________________________________E-mail�______________________________________

Continuing education fee of $25.00

Payment method

o Check enclosed

o Visa o MasterCard o American Express o Discover

Name on card �_________________________________________________________________________________

Card Number # �_______________________________________________________________Exp�date�__________

Signature�_____________________________________________________________________________________

A B C D A B C D

1. a b c d 11. a b c d

2. a b c d 12. a b c d

3. a b c d 13. a b c d

4. a b c d 14. a b c d

5. a b c d 15. a b c d

6. a b c d 16. a b c d

7. a b c d 17. a b c d

8. a b c d 18. a b c d

9. a b c d 19. a b c d

10. a b c d 20. a b c d


23


YOU MAY PHOTOCOPY THIS PAGE.

Evaluation

Our�aim�is�to�provide�high-quality�learning�resources�for�health�care�professionals.�We�need�your�help!�Now�that�you�have�

used�this�resource,�please�let�us�know�what�you�think!�Please make sure to completely fill in each circle you select.

1. The extent to�which�the�self-learning�package�met�the�stated�objectives: . . . . . . . . . . . . . . e g f p

2. Extent to which this self-learning package met my personal learning goals. . . . . . . . . . . . . . . e g f p

3. Information was clear, concise and well-organized . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e g f p

4. Theoretical information given was relevant to clinical situations . . . . . . . . . . . . . . . . . . . . e g f p

5.� Rate�the�following: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

� •�Satisfaction�with�ordering�and�shipping. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e g f p

� •Clarity�of�instructions�for�completing�the�self-learning�package . . . . . . . . . . . . . . . . . . . . e g f p

6.� Overall,�this�self-learning�package�was: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e g f p

7. How long did it take you to complete this self-learning package? . . . . . . . . . . . . . . . . �__________________________

8. Professional Credentials (check all that apply)

RN MD FACCE or other childbirth certification

Certified by NCC CLC Other�_____________________________________________

CNM IBCLC

RD CLE

9. What was your main reason for purchasing this self-learning package?

To earn CERPs or L-CERPS for recertification

To earn contact hours for nursing (“CEUs”)

To earn recognition for other profession(s)

Price was reasonable

To earn credits at my own pace

Other�_________________________________

10. How did you hear about this self-learning self-learning package?

Flyer in the mail to you or to workplace

Coworker, supervisor or friend told me

Breastfeeding Outlook web site

E-mail lists

ILCA web site

Other�_________________________________

Excellent Good Fair Poor


24

YOU MAY PHOTOCOPY THIS PAGE.

Evaluation (continued)

11. Is a self-learning self-learning package an effective learning tool for you? Why or why not?

12. Would you recommend this self-learning package to a colleague? Why or why not?

13. How long did it take you to complete this self-learning package?

14. How could it be improved?

15.��We�would�like�to�develop�more�self-learning�self-learning�packages�to�meet�your�needs!�Please�check�the�topics�you�

would�be�interested�in:�

Breastfeeding the Preterm Newborn Candida:�Implications�for�Breastfeeding�Couplets

Helping the Infant with Failure to Thrive Breastfeeding Infants with Special Needs (Cleft, etc.)

Breastfeeding Medications During Labor Predicting and Preventing Early Breastfeeding Cessation

Breastfeeding and Maternal Postpartum Other (please specify)�________________________________

Medications �_________________________________________________

Ethics and the Lactation Professional

Thank you for your feedback!

Please�send�your�completed�evaluation�form�to:

Breastfeeding Outlook, Dept. CE

� PO�Box�387��•��Herndon�VA�20172��

� Or�fax�to:�703-787-9895


25

P.O. Box 387Herndon, VA 20172

703-787-9894 • Fax: 703-787-9895

Breastfeeding Outlook: A Review of 2006–2007

Do you ever feel like you're too busy with your clients to know what's going on in the outside world? Are you looking to update your knowledge before taking the IBLCE exam? Are you a Breastfeeding Outlook subscriber who's looking for a chance to earn continuing education credits? This handy self-learning package is just what you need!

It will help you:

• Describe current studies in breastfeeding and lactation management

• Counsel mothers appropriately, based on emerging issues and trends

• Describe new technologies that support breastfeeding

• Describe new statements and efforts by national and international organizations

Plus, it includes evidence-based guidance about pierced nipples, peanuts, the risks of infant formula, MRSA, and much, much more!

Earn Continuing Education Recognition

The Simplifying Breastfeeding Management series is designed to help lactation consultants, nurses, dietitians, childbirth educators, and other health care professionals to enhance their breastfeeding promotion skills. These user-friendly packages make it easy to:

• Earn continuing education credits towards your license or certification renewal.

• Learn evidence-based practice when and where it is convenient for you.

• Update your staff's knowledge of breastfeeding with research-based strategies.

7819319 048200

ISBN 1-931048-20-7

90000>

Download version without newsletters

a review of 2006–2007 - breastfeeding outlook · a review of. 2006–2007. simplifying...

Documents