Professional Documents
Culture Documents
8
Summary
Key Concepts
Internet Resources
References
Appendix 7-A: Research and Scholarly Papers on the Newborn’s Reactions
to the Smell of Mother’s Milk or Secretions from the Montgomery Glands
on the Areola
9
Dermatoses of the Breast
Candidiasis (Thrush)
Other Breast Pain
Milk Blister
Mammoplasty
Breast Lumps and Surgery
Galactoceles
Fibrocystic Changes of the Breast
Bleeding from the Breast
Breast Cancer
Clinical Implications
Acknowledgement
Summary
Key Concepts
Internet Resources
References
10
References
11
Internet Resources
References
Appendix 12-A: Manufacturers and Distributors of Breast Pumps and
Feeding Equipment
12
Informed Decision Making
Wet-Nursing, Informal Sharing, and Sale of Milk
For-Profit and Not-for-Profit Milk Banking
Research Findings on Donor Milk
Selected Case Studies
A Tribute to Mary Rose Tully
Summary
Key Concepts
Internet Resources
References
Appendix 14-A: Expressing, Storing, and Handling Human Milk
13
Introduction
Historical Perspective and Statistics on Maternal Employment
The Effect of Work on Breastfeeding
Facilitators and Barriers to Breastfeeding in the Workplace
Individual Strategies to Manage Breastfeeding and Work
Special Issues Related to Returning to Work
Workplace Strategies to Support Breastfeeding and Work
Community Strategies to Support Breastfeeding and Work
National and Global Strategies in Promoting and Supporting Breastfeeding
Clinical Implications
Summary
Key Concepts
Internet Resources
References
14
Team Care for the Child with Feeding Difficulties
Feeding Behaviors of the Ill Infant/Child
What to Do If Weight Gain Is Inadequate
Pain Management Concerns
Breastfeeding Care of the Hospitalized Infant
Perioperative Care of the Breastfeeding Infant/Child
Emergency Room
Care of Children with Selected Conditions
Alterations in Neurologic Functioning
Congenital Heart Disease
Oral/Facial Anomalies
Gastrointestinal Anomalies and Disorders
Metabolic Dysfunction
Allergies
Food Intolerance
Psychosocial Concerns
Acknowledgment
Summary
Key Concepts
Internet Resources
References
15
SECTION V Sociocultural and Research Issues
16
Introduction
The Dominant Culture
Ethnocentrism Versus Relativism
Cultural Competence
Assessing Cultural Practices
Language Barriers
The Effects of Culture on Breastfeeding
Maternal Foods
Weaning
Implications for Practice
Summary
Key Concepts
Internet Resources
References
17
Preface
It is with great pride that I assume the lead editor position for Breastfeeding and
Human Lactation, Fifth Edition. This is the final edition of the book that Dr. Jan
Riordan, the book’s founding editor and honorary editor of this edition, will
participate in. I gratefully acknowledge Dr. Riordan’s historic efforts and
accomplishments in making this textbook the classic resource that it has come to be.
I personally am grateful to Jan for her long-time mentoring and recognition of me as
worthy of “taking over the book.”
Changes to this Fifth Edition are plentiful and hopefully useful to our readers.
We now have 23 chapters in the book, down from 25. Some content from the two
deleted chapters has been incorporated elsewhere. Extensive changes and revisions
were made to some chapters, while fewer revisions/changes were made to others.
We are fortunate that the evidence underlying the science of breastfeeding and
human lactation continues to grow, and we have done our best to include such
evidence in the chapters. We welcome several new contributors to the book and we
acknowledge those who took on chapters previously authored by Dr. Riordan. Our
goal was to include knowledgeable experts, and we believe we have done so. On a
sad note, we mourn the passing of Mary Rose Tully, and at the same time, laud
Frances Jones’s sole authorship of the chapter on human milk banking.
Since the last edition of the book, many advances have been made in the
promotion and support of breastfeeding in the United States and around the world.
For example, in the United States the Healthy People 2020 goals expanded to
further support breastfeeding and exclusive breastfeeding by including goals related
to increasing breastfeeding support in the workplace, reducing formula
supplementation in the hospital in the first two days of life, and increasing the
proportion of births that occur in facilities that provide recommended care and
support of lactating mothers and their infants. The Surgeon General’s 2011 Call to
Action to Support Breastfeeding brought additional attention to how breastfeeding
women can be supported by the healthcare community (including lactation
consultants), employers, community leaders, family and friends, and policy makers.
The Patient Protection and Affordable Care Act (ACA) of 2010 incorporated
provisions to reimburse costs for lactation care and breast pumps. The act also
amended the Fair Labor Standards Act (FLSA) to require employers to provide
break time and a private location to express breastmilk for non-exempt employees.
In 2011, the Centers for Disease Control and Prevention (CDC) and the National
Institute for Child Health Quality (NICHQ), in collaboration with Baby-Friendly
USA and the United States Breastfeeding Committee, collaborated in Best Fed
18
Beginnings, a first-of-its-kind, nationwide quality improvement initiative to help 89
hospitals improve maternity care and increase the number of Baby-Friendly-
designated hospitals in the United States. In 2013, the CDC published the CDC
Guide to Strategies to Support Breastfeeding Mothers and Babies. All of these
efforts demonstrate our government’s recognition of the health value of
breastfeeding.
As lactation care providers, educators, and researchers, we have an obligation
to do our part in enhancing support for breastfeeding mothers. We hope our book
provides the evidence and information on practical application of that evidence in
support of breastfeeding mothers.
Birth practices affect lactation. Thus, this edition again contains considerable
content on obstetrical issues, especially the importance of skin-to-skin care and
keeping mothers and babies together 24 hours a day during the birth hospitalization.
Maternity practices and obstetrical intervention that impact breastfeeding have
gained considerable attention from professional healthcare organizations. This is
good news for efforts to support breastfeeding initiation and continuation.
Examples include the American College of Obstetrics and Gynecology efforts to
reduce cesarean section and the Association of Women’s Health, Obstetric and
Neonatal Nursing campaign to reduce elective induction of labor prior to 39 weeks’
gestation.
As is true of earlier editions, the fifth edition of this text has a clear clinical
focus. Nearly every chapter contains a clinical implications section. Important
concepts discussed in chapters are summarized at the end of each chapter—a
feature that makes studying easier. Throughout the book are new references deemed
by the authors to be the most important from the vastly expanded research and
clinical literature. Some older references—which introduced then-new ideas that
are now accepted common knowledge—have been removed to make room for the
new.
Section 1 contrasts the past and present. Chapter 1, with three new esteemed
authors, concentrates on the work of the present-day healthcare worker who
specializes in lactation and breastfeeding, and it addresses work-related issues of
lactation consulting, such as staffing. Chapter 2 presents the history of breastfeeding
by placing lactation and breastfeeding in its historical context.
Section 2 focuses on basic anatomic and biologic imperatives of lactation.
Researchers continue to find amazing properties in breastmilk, such as stem cells.
Clinical application of techniques must be based on a clear understanding of the
relationships between form, function, and biological constructs. Chapter 3 has a
section on basic suck-training technique for infants with suckling problems. This
section, too, provides the background upon which to understand other aspects of
lactation and breastfeeding behavior.
19
Section 3 is the clinical “heart” of the book, and describes the basics of what to
do, when to do it, and how to do it when one assists the lactating mother. Section 3
thus concerns itself with the perinatal period in the birth setting and concerns during
the postpartum period following the family’s return home—notably breast
problems, neonatal jaundice, and infant weight gain. This section also addresses
special needs of preterm and ill babies and their mothers, and it critically evaluates
breastfeeding devices and recommends how and when they are most appropriately
used. It concludes with a review of the development and current activities of human
milk banking.
The first part of Section 4 focuses on the mother: the mother’s health and
returning to work. The topics then turn to the infant’s health and special health
needs. The techniques of infant assessment are explained and demonstrated with
photographs.
Section 5 begins with a careful look at research—how it is conducted, why
ongoing research is needed, how research findings can be applied in clinical
settings, and what theories are related to lactation practice. The principles of
education, the cornerstone of clinical practice, are explored next. The book
concludes with chapters on culture’s effect on breastfeeding and the sociological
context of the breastfeeding family functions.
To avoid linguistic confusion, the book uses the following conventions. The
masculine pronoun has been used to denote the infant or child throughout the text as
a matter of convenience to distinguish the child from the breastfeeding mother.
Nurses, lactation consultants, and other healthcare workers are referred to by
feminine pronouns, although we recognize that men serve in all healthcare
professions.
20
Acknowledgments
We gratefully acknowledge the contributions to this book made by the following
individuals:
Mary Margaret Coates, MS, IBCLC, TECH Edit, Wheat Ridge, Colorado
Nancy Powers, MD, FAAP, FABM, University of Kansas School of Medicine,
Wichita
Miriam Labbok, MD, MPH, Director, Carolina Global Breastfeeding Institute,
University of North Carolina, Chapel Hill
Sandi Hudson
Genevieve Barrett
Mandy McKinley
Tiffany Lemanski
Liza Murray
Alicia Reeves
Colleen Britt
We are grateful to La Leche League International for providing the foundation for
our breastfeeding knowledge and to those institutions that encouraged and
supported us in writing the book over the years: The University of Kansas School
of Nursing in Kansas City, Kansas, as well as the Wichita State University School
of Nursing and Via Christi Regional Medical Center, both of Wichita, Kansas.
Finally, we would like to thank our families for their help and encouragement
over the years:
The Wambach family: Bill; Jackie, Brian, and Brianne; and Nathan, Sugar,
Logan, and Samantha.
The Riordan family: Michael, Neil, and Shirley; Brian, Quinn, and Rika; Teresa,
Renee, and Don Olmstead; and 12 grandchildren.
21
Contributors
Heather Baker, MSN, APRN, PNP
Clinical Educator, Retired
School of Nursing
Wichita State University
Wichita, Kansas
E. Stephen Buescher, MD
Professor of Pediatrics
Eastern Virginia Medical School
Norfolk, Virginia
Mary-Margaret Coates, MS
Technical Editor
TECH Edit
Wheat Ridge, Colorado
Jolynn Dowling
Clinical Instructor
School of Nursing
Wichita State University
Wichita, Kansas
22
University of Chicago
Chicago, Illinois
23
Wichita State University
Wichita, Kansas
24
Professor of Perinatal Nursing and Helen
M. Shearer Professor of Nutrition
University of Pennsylvania School of Nursing
Nurse Researcher and Manager of the Lactation
Program
Children’s Hospital of Philadelphia
Philadelphia, Pennsylvania
25
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hommes et des femmes
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Contributor: Horace
Language: French
A LA REYNE.
M. D C . XX II .
A LA REYNE.
adame,
MADAME,
Tres-humble & Tres-obeiſſante
ſeruante & ſubjecte.
Gournay.
EGALITÉ DES HOMMES ET
DES FEMMES.
Ont elles au ſurplus, (ce mot par occaſion) moins excellé de foy, qui comprend toutes
les vertus principales, que de ſuffiſance & de force magnanime & guerriere?
Paterculus nous apprend, qu’aux proſcriptions Romaines, la fidelité des enfãs fut
nulle, des affranchis legere, des femmes treſgrande. Que ſi Sainct Paul, ſuyuãt ma
route des teſmoignages ſaincts, leur deffend le miniſtere & leur commande le ſilence
en l’Egliſe: il eſt euident que ce n’eſt point par aucun meſpris: ouy bien ſeulement, de
crainte qu’elles n’eſmeuuent les tentations, par cette montre ſi claire & publique qu’il
faudroit faire en miniſtrant & preſchant, de ce qu’elles ont de grace & de beauté plus
que les hommes. Ie dis que l’exemption de meſpris eſt euidente, puiſque cet Apoſtre
parle de Theſbé comme de ſa coadiutrice en l’œuure de noſtre Seigneur, ſans toucher
le grand credit de Saincte Petronille vers ſainct Pierre: & puis auſſi que la Magdeleine
eſt nommée en l’Egliſe egale aux Apoſtres, par Apoſtolis. Voire Entre autres au
que l’Egliſe & eux-meſmes ont permis vne exception de ceſte Calendrier des Grecs,
reigle de ſilence pour elle, qui preſcha trente ans en la Baume de publié par Genebrard.
Marſeille au rapport de toute la Prouence. Et ſi quelqu’vn
impugne ce teſmoignage de predications, on luy demandera que faiſoient les Sibyles,
ſinon preſcher l’Vniuers par diuine inſpiration, ſur l’euenement futur de Ieſus-Chriſt?
Toutes les anciennes Nations cõcedoient la Preſtriſe aux fẽmes, indifferemment auec
les hommes. Et les Chreſtiens ſont au moins forcez de conſentir, qu’elles ſoyent
capables d’appliquer le Sacrement de Bapteſme: mais quelle faculté de diſtribuer les
autres, leur peut eſtre iuſtement deniée; ſi celle de diſtribuer ceſtuy-là, leur eſt iuſtement
accordé? De dire que la neceſſité des petits enfãs mourãs, ait forcé les Peres anciens
d’eſtablir cet vſage en deſpit d’eux: il eſt certain qu’ils n’auroient iamais creu que la
neceſſité les peuſt diſpenſer de mal faire, iuſques aux termes de permettre violer &
diffamer l’application d’vn Sacrement. Et partant concedans ceſte faculté de
diſtribution aux femmes, on void à clair qu’ils ne les ont interdites de diſtribuer les
autres Sacremẽs, que pour maintenir touſiours plus entiere l’auctorité des hommes;
ſoit pour eſtre de leur ſexe, ſoit afin qu’à droit ou à tort, la paix fuſt plus aſſeurée entre
Epiſt. les deux ſexes, par la foibleſſe & rauallement de l’vn. Certes ſainct Ieroſme eſcrit
ſagement à noſtre propos; qu’en matiere du ſeruice de Dieu, l’eſprit & la doctrine
doiuent eſtre conſiderez, non le ſexe. Sentence qu’on doit generaliſer, pour permettre
aux Dames à plus forte raiſon, toute action & ſciẽce honneſte: & cela ſuyuant auſſi les
intentions du meſme ſainct, qui de ſa part honnore & auctoriſe bien fort leur ſexe.
Dauantage ſainct Iean l’Aigle & le plus chery des Euangeliſtes, ne meſpriſoit pas les
fẽmes, non plus que ſainct Pierre, ſainct Paul & ces deux Peres, i’entends ſaint Baſile
& ſainct Ieroſme; puis qu’il leur addreſſe ſes Epiſtres particulieremẽt: ſans Electra.
parler d’infinis autres Ss: ou Peres, qui font pareille addreſſe de leurs Eſcrits.
Quand au faict de Iudith ie n’en daignerois faire mention s’il eſtoit particulier, cela
s’appelle dependant du mouuement & volonté de ſon auctrice: non plus que ie ne
parle des autres de ce qualibre; bien qu’ils ſoient immenſes en quantité, comme ils
ſont autant heroiques en qualité de toutes ſortes, que ceux qui couronnent les plus
illuſtres hommes. Ie n’enregiſtre point les faicts priuez, de crainte qu’ils ſemblent, non
aduantages & dons du ſexe, ains boüillons d’vne vigueur priuée & ſpecialle. Mais
celuy de Iudith merite place en ce lieu, parce qu’il eſt bien vray, que ſon deſſein
tombant au cœur d’vne ieune dame, entre tant d’hommes laſches & faillis de cœur, à
tel beſoing, en ſi haulte & ſi difficile entrepriſe, & pour tel fruict, que le ſalut d’vn Peuple
& d’vne Cité fidelle à Dieu: ſemble pluſtoſt eſtre vne inſpiration & prerogatiue diuine
vers les femmes, qu’vn traict purement voluntaire. Comme auſſi le ſemble eſtre celuy
de la Pucelle d’Orleans, accompagné de meſmes circonſtances enuiron, mais de plus
ample & large vtilité, s’eſtendant iuſques au ſalut d’vn grand Royaume & de ſon Prince.
Æneid. I.
alluſion. Cette illuſtre Amazone inſtruicte aux ſoins de Mars,
Fauche les eſcadrons & braue les hazars:
Veſtant le dur plaſtron ſur ſa ronde mammelle,
Dont le bouton pourpré de graces eſtincelle:
Pour couronner ſon chef de gloire & de lauriers,
Vierge elle oſe affronter les plus fameux guerriers.
Adjouſtons que la Magdelene eſt la ſeule ame, à qui le Redempteur ait iamais
prononcé ce mot, & promis cette auguſte grace: En tous lieux où ſe preſchera
l’Euangile il ſera parlé de toy. Ieſus-Chriſt d’autrepart, declara ſa tres heureuſe & tres
glorieuſe reſurrection aux dames les premieres, affin de les rẽdre, dit vn venerable
Pere ancien, Apoſtreſſes aux propres Apoſtres: cela, cõme lon ſçait, auec miſſion
expreſſe: Va, dit il, à cette cy meſme, & recite aux Apoſtres & à Pierre ce que tu as
veu. Surquoy il faut notter, qu’il manifeſta ſa nouuelle naiſſance eſgalement aux
femmes qu’aux hommes, en la perſonne d’Anne fille de Phannel, qui le recongneut en
meſme inſtant, que le bon vieillard Sainct Simeon. Laquelle naiſſance, d’abondant, les
Sybilles nommées, ont predite ſeules entre les Gentils, excellent priuilege du ſexe
feminin. Quel honneur faict aux femmes auſſi, ce ſonge ſuruenu chez Pilate;
s’addreſſant à l’vne d’elles priuatiuement à tous les hommes, & en telle & ſi haulte
occaſion. Et ſi les hommes ſe vantent, que Ieſus-Chriſt ſoit nay de leur ſexe, on reſpond,
qu’il le failloit par neceſſaire bien ſceance, ne ſe pouuant pas ſans ſcandale, meſler
ieune & à toutes les heures du iour & de la nuict parmy les preſſes, aux fins de
conuertir, ſecourir & ſauuer le genre humain, s’il euſt eſté du ſexe des femmes:
notamment en face de la malignité des Iuifs. Que ſi quelqu’vn au reſte eſt ſi fade;
d’imaginer maſculin ou feminin en Dieu, bien que ſon nom ſemble ſonner le maſculin,
ny conſequemment beſoin d’acception d’vn ſexe pluſtoſt que de l’autre, pour honnorer
l’incarnation de ſon fils; cettuy cy monſtre à plein iour, qu’il eſt auſſi mauuais Philoſophe
que Theologien. D’ailleurs, l’aduantage qu’ont les hommes par ſon incarnation en leur
ſexe; (s’ils en peuuent tirer vn aduantage, veu cette neceſſité remarquée) eſt cõpenſé
par ſa conception tres precieuſe au corps d’vne femme, par l’entiere perfection de
cette femme, vnique à porter nom de parfaicte entre toutes les creatures purement
humaines, depuis la cheute de nos premiers parens, & par ſon aſſumption vnique en
ſuiect humain auſſi.
Finalement ſi l’Eſcripture a declaré le mary, chef de la femme, la plus grande ſottiſe
que l’homme peuſt faire, c’eſt de prendre cela pour paſſedroict de dignité. Car veu les
exemples, aucthoritez & raiſons nottées en ce diſcours, par où l’egalité des graces &
faueurs de Dieu vers les deux eſpeces ou ſexes eſt prouuée, voire leur vnité meſme, &
veu que Dieu prononce: Les deux ne ſeront qu’vn: & prononce encores: L’hõme
quittera pere & mere pour ſuiure ſa femme; il paroiſt que cette declaration n’eſt faicte
que par le beſoin expres de nourrir paix en mariage. Lequel beſoin requeroit, ſans
doubte, qu’vne des parties cédaſt à l’autre, & la preſtance des forces du maſle ne
pouuoit pas ſouffrir que la ſoubmiſſiõ vĩt de ſa part. Et quand bien il ſeroit veritable,
ſelon que quelques vns maintiennent, que cette ſoubmiſſion fut imposée à la femme
pour chaſtiement du peché de la pomme: cela encores eſt bien eſloigné de conclure à
la pretendue preferance de dignité en l’homme. Si lon croioit que l’Eſcripture luy
commendaſt de ceder à l’homme, comme indigne de le contrecarrer, voyez l’abſurdité
qui ſuiuroit: la femme ſe treuueroit digne d’eſtre faicte à l’image du Createur, de iouyr
de la treſſaincte Eucariſtie, des myſteres de la Redemptiõ, du Paradis & de la viſion
voire poſſeſſion de Dieu, non pas des aduantages et priuileges de l’homme: ſeroit ce
pas declarer l’homme plus precieux & releué que telles choſes, & partant commettre
le plus grief des blaſphemes?
FIN.
L’ I M P R I M E V R A R A N G É
ces vers icy pour emplir le reſte
de la feuille.
AVTHEVR INCERTAIN.
VERSION.
AVTREMENT
Lyſe & ſon petit Lys außy beaux que les Dieux,
De deux coſtez diuers ont perdu l’vn des yeux.
Si Lys donne l’autre œil à ſa mere admirée;
Il eſt l’aueugle Amour, & Lyſe Cytherée.
EX HORATIO.
Dial.
VERSION