 |
|
|
|
|
|
La Leche League International's The Breastfeeding Answer Book, Third Revised Edition Written by Nancy Mohrbacher, IBCLC and Julie Stock, MA, IBCLC Reviewed by: Ruth Piatak, BA, MS, LLL Leader In its third edition, The Breastfeeding Answer Book remains, as SDCBC member Audrey Naylor, MD, DrPH states in her foreword, a "practical yet scientifically sound" resource for those helping mothers to breastfeed. In their introduction, Mohrbacher and Stock remark how much has changed in breastfeeding since 1996. The new edition does a lot to keep abreast of these changes. There is extensive treatment of significant developments in research and clinical realities. The rise in women of childbearing age dealing with deadly viruses, breast surgery, substance abuse, and obesity has led to more research and more thorough treatment of these topics in the new edition. La Leche League's approach to women as mothers first, and patients second, comes through in the more thorough discussion of diagnosis and treatment options for mothers with cancer and postpartum depression, and recent research on the effects of maternal depression on infant development. Changes in childbearing figure greatly in the revisions. The most striking is the inclusion of material on breastfeeding after cesarean delivery in the "Breastfeeding Basics" chapter. (This will certainly be seen by many as a capitulation of La Leche League philosophy to the realities of American medical practice.) The greater number of infants who survive premature birth has led to extensive research on the benefits of breastmilk for them and the clinical practices which best support the establishment of breastfeeding. The supplement on breast pumps and other products has changed quite a bit. There is much less detail about the relative characteristics of particular pumps and nursing supplementers. This seems appropriate - products and their features come and go, and a product that one breastfeeding helper finds easy to teach mothers to use may disappoint |
|
another. Company website addresses and other contact information are provided so that current information can be found. New "gadgets" discussed at length in the supplement and/or appropriate chapters include palatal obturators, silicone nipple shields, and hydrogel pads. The new edition of The Breastfeeding Answer Book is more international in scope. Examples noted include ultrasound research on breast anatomy and milk production in Australia, clinical advances in lactation induction in Canada, kangaroo care of premature infants in Zimbabwe, trials of the effect of infant feeding practices on HIV transmission in South Africa, and the effects of breastfeeding during pregnancy on malnourished women in Guatemala. Several changes in the third edition reflect the authors' belief that breastfeeding (and breastfeeding help) is "an art and not a science". There is more attention throughout to the interaction of maternal and infant characteristics. Photos of live people demonstrating such things as latching and simultaneous nursing of twins are a welcome addition. Observations of the effects of breastfeeding management "risk factors" on such problems as mastitis are plentiful. This third edition marks a lot of changes in breastfeeding realities and breastfeeding help in recent years. It is nevertheless remarkable how much is the same. As always, child rearing is a profoundly social activity. (The woman pregnant for the first time is struck by this fact when perfect strangers are full of questions and comments as soon as her pregnancy starts to show.) The strength of The Breastfeeding Answer Book in this edition, as in the others, is its treatment of breastfeeding in its social context. The first chapter focuses on "Giving Effective Breastfeeding Help". Sections such as "The Mother's Feelings", "Helping the Mother Work with Her Baby's Doctor", and "Mother Care for the Mother of Multiples" are an integral part of many chapters. This is where the "art" of breastfeeding help really comes into play-when we can help mothers cope and babies thrive in the "real" world. Breastfeeding helpers of many different backgrounds can benefit from the cumulative information -- and wisdom - presented by The Breastfeeding Answer Book. |
|
