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DawnL Offline OP
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Hi, all!
I know Lenore doesn't go the ABRW anymore, so I know she wouldn't get a chance to respond to this. I am not trying to start anything, I just honestly want to know what Lenore thinks of this, and what her response is. I don't know who this person is that originally posted this. Hopefully no one will be offended that I copied this over, as that certainly wasn't my intention.


I'm afraid there has been a bit of a misunderstanding about my position on the Newman-Goldfarb protocols for inducing lactation. I spoke to Lenore last spring as I was preparing the lectures for the LLL Lactation specialist series which I have now given at several sites in the US. This protocol is one of several currently or recently in use which I discuss during the lecture. Each protocol is examined critically and concerns are clearly spelled out. Inclusion of a protocol does not imply endorsement. I would not consider myself "supportive" of the Newman-Goldfarb protocol. There is as yet no published research on it. It has, however, been used by a number of women and it is my understanding that a formal article is in preparation. My concerns are twofold: the women following it are on a lot of medication for prolonged periods - and the results have not, on average, been better than those achieved by many women using protocols involving less medical intervention - or no protocol at all except the baby at the breast. As much as any other person involved in this area, I'd like to see a safe intervention that makes both relactation and induced lactation easy. Thus far the best intervention - besides the obvious one of putting the baby to breast a lot - is growing up in a culture where everyone believes that people with breasts can breastfeed.

Warm Regards,
Elizabeth Hormann

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nbduane
(Owner/Creator ABRW)
10/10/02 01:08 AM
Re: My Position On The Newman-Goldfarb Protocols [re: elizabethhormann] Reply




Hello all...

To review Elizabeth Hormman's credentials Please click on the highlighted link and go half way down on the following page. I'd cut and paste her credentials myself... but I don't want to infringe on any copyrighted information.

Kind Regards,
Naomi B. Duane



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Karleen
(Extra Helpful Experienced Member)
10/10/02 03:15 AM
Re: My Position On The Newman-Goldfarb Protocols [re: elizabethhormann] Reply




Thankyou for coming to the group to clarify your opinion for us. I agree 100% with the quote below!
Karleen Gribble
Australia

"Thus far the best intervention - besides the obvious one of putting the baby to breast a lot - is growing up in a culture where everyone believes that people with breasts can breastfeed. "



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Sutherland
(Boot Camp Moderator)
10/10/02 01:09 PM
Re: My Position On The Newman-Goldfarb Protocols [re: elizabethhormann] Reply




Guten tag Elizabeth- long time no see. As someone who has always been both very open minded and who shared the wisdom of your experience with breastfeeding, I for one am happy to see your post here.
Tracking the experiences of those who have used the Newman Protocol, we see a variety of results. Some feel it is the only answer to every bf challenge and that can only lead to disappointment. The is no one thing fits all answer as every situation comes with its own unique aspects.
For those with the funds, time, patience, and a sure due date, the results can be good as long as mother's health permits and she does not mind using milk that has herbs & meds added. The big focus on milk production can also diminish the great emotional satisfaction that is part of nursing.
Having simply bf an adopted daughter with a supplementer, my supply grew slowly, but the fulfillment was equal to full milk production with my bio babies. We simply nursed tiwce as long to provide about the same amount of milk and it was no big deal.
Hope all is well with you and yours and that you drop in here when time permits as we can all benefit from your experience...Ann




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Hi Dawn,

Thank you for bringing this to my attention. Since I've been away from ABRW and busy setting up this new message board, I haven't been to the ABRW site much if at all. And since my IP address had been banned, I am unable to post or respond to this type of thing over there.

If you think this is something, you should see some of the posts that have been made by a certain member of ABRW recently, mostly questioning the protocols, domperidone, etc. on Lact-net. Carole has been handling them.

Before I left ABRW this particular member gave me a bit of a hard time. She's a mom who adopted an older child and got her to the breast with domperidone. She posted the WHO position paper on adoptive breastfeeding that Elizabeth Hormann co-wrote in 1998. I responded by saying the document was informative but that the information did not include the new protocols because they were only released in 2000. I said I had been in touch with Elizabeth Hormann and that she includes the protocols on her lecture tour and was supportive of them. (She was very supportive when she spoke with me, said Chele Marmet of the Lactation Institute had told her to get in touch with me, and has had email contact with me several times.) I have the utmost respect for Elizabeth Hormann and am convinced that her post was based on only one side of the story.

I think that in all likelyhood someone emailed her my comments on her document and that it was taken out of context of the general discussion and misunderstood. The 1998 WHO position paper was an excellent and well researched review of the available literature at that time. The document contains important and relevant information. But of course the protocols were not yet released when the document was prepared. That doesn't mean the WHO document isn't relevant.

The point that I was trying to make was that there is more information now. There is another way that works. We know this because at this point over 400 women have tried the protocols and have brought in their milk supplies. How do we measure success? Full milk supplies? Half milk supplies? To me, what is important is breastfeeding period. If the mother can bring in her milk too...why the heck not? As Carole recently put it, there are many ways to induce lactation. We have to assist the mother to weigh the risks and benefits of using medications that are filtered through the breast and that which is given directly to the baby. Remember, formula is modified cow's milk manufactured by a pharmaceutical company and therefore a form of over the counter medication.

I am of course very concerned about this post which I have no way to respond to. The statement that bothers me the most is this one " and the results have not, on average, been better than those achieved by many women using protocols involving less medical intervention - or no protocol at all except the baby at the breast."

We know that many women who have done the protocols have been able to breastfeed their babies from birth with a full milk supply. There is no way that a mother who has done no preparation whatsover is going to be able to fully breastfeed her baby from birth by just putting the baby to the breast. If one were to follow the logic of no preparation or minimal medication or preparation, one would also have to agree to the use of formula feeding from birth. And in fact, this is what tends to happen. It's inevitable that these babies end up formula fed from birth because they need to eat from birth right? There is not a single first time adoptive mother (who never lactated before) at ABRW who was able to just put the baby to the breast without any sort of preparation and breastfeed without a supplementer. And unless they were able to get banked human milk, their babies were formula fed.

I contacted Dr. Newman about this and he agreed with me but in all fairness, Elizabeth Hormann cannot publically endorse a protocol that has not yet appeared in a respected peer reviewed journal. Dr. Newman and I are aware of the need to put out a journal article and put this whole issue about the protocols to rest. In the meantime, he made a very good point, he said that since there is nothing yet published, how can Elizabeth Hormann say the results are not better?

I wish to add that when I left ABRW the membership was just over 200. So if every single mother there were on the protocols and if every single one posted a negative result, and since we've been in touch with over 400, where are the rest? The answer is that the majority of women on the protocols never heard of ABRW before they contacted either Dr. Newman or myself. So again, it's not a fair statement to discuss results that no one but Dr. Newman and myself are privy to.

Women at ABRW who posted difficulties often did not follow the protocols as witten for whatever reason. The most common problem was that they did not do the domperidone/birth control pill combination for any length of time or used a low dose bcp. A major issue was pumping. Women who pumped 2 or 3 times per day instead of at least the 8 times in 24 hours that we recommend had difficulties. Women who didn't use a double electric breast pump had difficulties. Women who didn't contact me for moral support when I was more than happy to assist had difficulties.

As for the comments of the other ladies...keep in mind who's responding. It's like the anti-medical members "bon voyage to the protocols" party. Although Dr. Newman and I have not as yet recinded our permission to post the protocols on ABRW, we suspect that they will not remain there much longer. If anyone is interested in reading them they can be found here:
http://www.asklenore.info/breastfeeding/induced_lactation/gn_protocols.html

Keep the faith everyone. We're working on the article. It takes time to accumulate and analyze all the data. If anyone would like to help, we're interested in the pediatric reports (specifially the growth charts) for any baby that was breastfed following the use of domperidone, Diane 35, herbs, pumping, Lact-aid/SNS, or a combination of any of these. We are also intersted in the pediatric reports of any babies who were breastfed without medications, just the Lact-aid or breast alone and then supplemented with bottles.

If you are interested in participating in our study, please contact me directly via the ask Lenore email link at the bottom of the page.

Well that's my opinion for what it's worth. I'm happy to have a place to voice it. Thanks Dawn for asking.

Fondly,


Lenore Goldfarb, Ph.D.,CCC,IBCLC
Wife to Rob, Mom to Adam aged 13, and Ethan aged 9, both born via GS and breastfed via Regular Newman-Goldfarb Protocol.
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Lenore,
a very supportive replay was posted to this thread... I think you will be pleased... go look <img src="http://www.asklenore.com/ubbthreads/images/icons/laugh.gif" alt="" />


Adoptive mommy to 4 , Last 2 adopted nursed. Youngest nursed till she was 5! Raising 2 grandbabies, as infants they were raised on donor breast milk smile
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DawnL Offline OP
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Hi, Lenore,
Thank you for your response. I didn't think it was fair to post that when you were not able to respond, and I was genuinely interested in your response.
The drugs do not seem all that much to me. If you follow the protocols the BCPs are already out of the system by the time you put the baby to breast. So you have Dom, and herbs. And I think that is a lot better than formula any day! I am really hoping to have a stash of breast milk before we get our baby, so we can avoid formula all together.
Thanks again, for your response and your support. I really appreciate it!!
DawnL


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Hi Nona and Dawn,

Yes, I agree, it's very unfair to be talked about and have things said when one cannot respond. That's one of the main reasons why I set up this message board. The other reason was that ladies who were on the protocols and doing well were uncomfortable posting for fear that one of the members advocating "natural" methods would give her a hard time.

In term of the protocols themselves, many mothers report that they don't mind the medications for the very reasons that you voiced, Dawn. A lot of these women have been through the infertility nightmare and find that the medications for the most part don't bother them at all. Many are so grateful to be able to breastfeed with their own milk and to achieve what many have said was impossible. Many women feel betrayed by their own bodies for not enabling them to bear children. Inducing lactation enables them to reclaim their self-esteem. So many women have told me that the moment they put their baby to the breast and breastfed with their own milk, wihout having to fumble with the Lact-aid or the SNS, that they felt "normal" for the first time in many years. Many first and second-time adoptive mothers report that inducing lactation facilitated their bonding experience with their baby.

I think the main issue for Elizabeth is that I made public the statement that she was supportive of the protocols because she includes them on her lecture tour (with our permission) which I interpreted as supportive. But I was obviously mistaken and for that I humbly appologize.

The unfortunate thing about all of this is that someone who has done so much good for adoptive breastfeeding and relactation had to get dragged into this to the detriment of all concerned.

Anyway, at this point Dr. Newman has asked me to let it all slide so that is what I'm going to do. I want to thank you for your support as always. And encourage you to continue to help the ladies who are new to adoptive breastfeeding to make informed choices.

Fondly,


Lenore Goldfarb, Ph.D.,CCC,IBCLC
Wife to Rob, Mom to Adam aged 13, and Ethan aged 9, both born via GS and breastfed via Regular Newman-Goldfarb Protocol.
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This is such a tricky issue, because I truly see both sides of it.

On one hand, we have Dr. Newman's protocol, which for many women has fantastic results. On the other is the more "traditional" methods of nipple stimulation, herbs, rest, water, etc. Both of them are legitimate and good ways to go, depending on our medical situations, adoption/surrogacy situations, personal values, etc.

I started the protocol before I knew Lenore. I was in contact with Dr. Newman, did lots of research, and decided what the heck? We had been selected by a birthmother in as sure a situation as can be, knowing that there's no such thing. I had the time to spare, wanted to do something in preparation for our potential baby, and have an interest in anything scientific or relating to breastfeeding. I wanted to be a science experiment for myself.

On the other hand, I'm also a fairly granola-type Mama too. We use cloth diapers, have a family bed, subscribe to the Compleat Mother, believe in homebirths, don't circumcise, etc. So I understand why women don't want to use synthetic hormones, or drugs unavailable in the US, to induce lactation, which is touted as such a natural thing. It's a fine line we walk in making these decisions.

I think the issue is that we've divided into two camps. The drugs, and the no drugs. What's most important is that we respect each other. I'm not pointing fingers. I did the protocol with great success, but I was in the most ideal situation. I live in Canada where the pills are readily available. But I think that the "no drug" camp is more upset with the way things are said. The tone, more than the information. Personalities clash, and I have gotten upset over various things many times too.

I agree with alot of the things Lenore says. I agree with alot of things the Mamas at the ABRW say too. I am in contact with all the original members of the ABRW, just as I email and talk to Lenore about issues.

We need to see the protocol as a fabulous resource for those who wish to follow it. But it's true that the regular protocol, with the longer time, is more effective, yet harder to plan and carryout with adoption uncertainties. This is one of the bigger issues brought up in the "no drug" camp. It's in important one, and there's no answer to it.

Synthetic hormones are dangerous, and aren't something we should take without good reason. If I didn't suffer from PCOS and follow the protocol, I'd never take them. But my circumstances aren't ideal, and my infertility has caused me to need birthcontrol pills. Kind of weird!?

This is how we all need to see it. As a valid choice either way. This whole issue is more of a personality clash than anything else.

I'm not trying to be the "voice of reason" or give my history, and I realize I might sound very condescending. I apologize.

Kerri
Adoptive Mama to Cole and Adam
IBCLC in training. Maybe next July? Not sure!

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Kerri,
I don't think your condescending at all! Your points are really quite on it. It is 2 different camps.. and if we can learn to respect each others opinions and values on it... that would be so fantastic! Every person is different.. and there for its up to the individual woman what route she would like to go...I myself am on the the extended protocol.. because the accelorated didn't do it for me. Thanks for your post.. I think it was needed <img src="http://www.asklenore.com/ubbthreads/images/icons/wink.gif" alt="" />


Adoptive mommy to 4 , Last 2 adopted nursed. Youngest nursed till she was 5! Raising 2 grandbabies, as infants they were raised on donor breast milk smile
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When I read that post I was SO MAD!! That put a bee in my bonnet! I mean to attack a professional who is basically banned from response UGH! I am so thankful to have this list! <img src="http://www.asklenore.com/ubbthreads/images/icons/laugh.gif" alt="" />


Shannon Randolph Mom to 13 month old Cassie (adopted from Vietnam) and 2 week old Will (homegrown)
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I am so thankful to...but if you have noticed on that thread... there is a lot of support for the protocols coming forth yahhhh!! <img src="http://www.asklenore.com/ubbthreads/images/icons/shocked.gif" alt="" />


Adoptive mommy to 4 , Last 2 adopted nursed. Youngest nursed till she was 5! Raising 2 grandbabies, as infants they were raised on donor breast milk smile

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