Breastfeeding is as much about the food as sex is about the sperm

Breastfeeding is as much about the food as sex is about the sperm. Although it’s primarily designed for survival, it’s part of an intimate loving physical relationship- the template for all relationships in life. So for success, it involves persistence, commitment, giving beyond what seems reasonable- and provides rewards beyond what is given. -Nan Jolly, South Africa:

At ABM’s 2010 Intenational Meeting, members from around the world submitted their breastfeeding clinical pearls and mythbusters. We’ll be sharing the Top Ten winners on the blog this week. Clinical pearls reflect the opinions of individual ABM members, not the organization as a whole.

For comprehensive, evidenced-based guidelines on breastfeeding management, check out ABM’s Clinical Protocols, available in multiple languages.

Clinical pearl: The Murphy Maneuver for diagnosing tongue tie

If baby is having trouble breastfeeding and you are not sure if he is tongue-tied, San-Diego pediatrician Dr. James Murphy suggests pushing your little finger to the base of the tongue on one side and sweeping it across the other side to see what you can feel. If you feel little or no resistance more than a small “speed bump,” then most likely there is no problem.

Should you feel a large speed bump that you can get past with a little more effort, it is most likely a “tree trunk” frenulum, a short, wide band of tissue buried in the floor of the mouth and attached to the base of the tongue. It usually, though not always, restricts tongue movements and causes latch problems even though it looks like there isn’t enough there to be a problem.

When you can’t sweep your finger across without pulling it back to “jump over a fence,” the frenulum is a fibrous band attached closer to the front of the tongue. It may be buried underneath the floor of the mouth or visible as an external web. If you see a narrow white streak running down the middle of the floor of the mouth that feels like a wire, it usually extends to the front of the tongue like a string. Pushing your finger into this “piano wire” frenulum will often cause the tip of the tongue to tilt downward and the center if the tongue to pull down and crease along the middle. “Tree trunk, “fence,” and “piano wire” frenulums are red flags for significant tongue function impairment.

At ABM’s 2010 Intenational Meeting, members from around the world submitted their breastfeeding clinical pearls and mythbusters. We’ll be sharing the Top Ten winners on the blog this week. Clinical pearls reflect the opinions of individual ABM members, not the organization as a whole.

For comprehensive, evidenced-based guidelines on breastfeeding management, check out ABM’s Clinical Protocols, including our protocol for managing Neonatal Ankyloglossia.

Clinical pearl: Break up plugged ducts with an electric toothbrush

Sometimes using the flat side of an electric toothbrush over a superficial duct plug in the breast helps them break up, a poor man’s ultrasound therapy. -Amy Evans, California

At ABM’s 2010 Intenational Meeting, members from around the world submitted their breastfeeding clinical pearls and mythbusters. We’ll be sharing the Top Ten winners on the blog this week. Clinical pearls reflect the opinions of individual ABM members, not the organization as a whole.

For comprehensive, evidenced-based guidelines on breastfeeding management, check out ABM’s Clinical Protocols.

NICU pearl: Cover the containers during pumping to make more milk

When mothers are initiating and maintaining lactation by expressing milk with a pump, cover the containers with a towel, a receiving blanket etc. When the moms stop staring at the bottles and counting every drop they are often surprised to see how much more milk they express. – Kathie Marinelli and Mary Lussier, Connecticut

ABM’s protocol on the NICU graduate going home offers evidence-based guidelines for supporting breastfeeding for NICU infants.

At ABM’s 2010 Intenational Meeting, members from around the world submitted their breastfeeding clinical pearls and mythbusters. We’ll be sharing the Top Ten winners on the blog this week. Clinical pearls reflect the opinions of individual ABM members, not the organization as a whole.

Clinical pearl: Use the cord clamp to bring babies back at 3-5 days

In order to assure that every newborn is brought back to follow-up clinic between 3-5 days of age as recommended by the AAP, many years ago we instituted a policy in our hospital (The University of Chicago Hospitals) that all newborns would be discharged with the cord clamp remaining in place. When the infant completed the follow-up visit, we held a little ceremony to celebrate the removal of the cord clamp. Over a period of many years, we consistently had better than 90% returns to the early follow-up clinic. – Larry Gartner, Illinois and California

At ABM’s 2010 Intenational Meeting, members from around the world submitted their breastfeeding clinical pearls and mythbusters. We’ll be sharing the Top Ten winners on the blog this week. Clinical pearls reflect the opinions of individual ABM members, not the organization as a whole.

Clinical pearl: A quick fix for vasospasm

My trick is: when I see a mother with vasospasm after nursing in our outpatient Breastfeeding Medicine Clinic, I will give her heel warmers to put in her bra to relieve the spasm on the trip home. – Sarah Riddle, Ohio

At ABM’s 2010 Intenational Meeting, members from around the world submitted their breastfeeding clinical pearls and mythbusters. We’ll be sharing the Top Ten winners on the blog this week. Clinical pearls reflect the opinions of individual ABM members, not the organization as a whole.

Clinical pearl: Your baby has not read any of your books

Your baby has not read any of your books; he relies on a special software program for babies called instinct! Parents can quickly learn their baby’s language by the immersion method: stay close, listen, watch and practice. – Verity Livingstone, Canada

At ABM’s 2010 Intenational Meeting, members from around the world submitted their breastfeeding clinical pearls and mythbusters. We’ll be sharing the Top Ten winners on the blog this week. Clinical pearls reflect the opinions of individual ABM members, not the organization as a whole.

Clinical pearl: Give baby until 4 days past his due date to get the hang of breastfeeding

My pearl of wisdom is for moms who are having difficulty with breastfeeding that they need to give the baby until 4 days past his due date to get the hang of it, We see so many c-sections and planned inductions that some days the majority of our babies are 2-4 weeks early. Moms seem to understand this and many seem willing to try the extra work to get to this date (keep supplementing, keep waking, keep pumping). Of the mom and baby pairs that have continued to BF only 2 babies let me down by not catching on by the date. One of them had developmental delay. – ABM Member Gail Hertz, Pennsylvania, USA.

At ABM’s 2010 Intenational Meeting, members from around the world submitted their breastfeeding clinical pearls and mythbusters. We’ll be sharing the Top Ten winners on the blog this week. Clinical pearls reflect the opinions of individual ABM members, not the organization as a whole.