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>Date: Wed, 6 Oct 1999 09:04:36 +0100
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>To: [log in to unmask]
>From: majella <[log in to unmask]>
>Subject: Re:Introducing Myself and questions re sponsorship
>
>>Date: Wed, 06 Oct 1999 08:54:49
>>To: [log in to unmask]
>>From: majella <[log in to unmask]>
>>Subject: Re:Introducing Myself and questions re sponsorship
>>
>>>Return-Path: <[log in to unmask]>
>>>From: [log in to unmask]
>>( I am forwarding this for my friend who is having e-mail gliches and this
comes via my ARM e-mail address-K.A.)
>>>
>>>Coming out of the closet
>>>
>>>Introducing Myself and questions re sponsorship
>>>
>>>I have been a silent reader on both the ARM /Jane Sandal's research list
>>>for several months and feel such a kinship with our midwifery struggles
>>>that I have decided to come out of the closet.
>>>
>>>I am a research midwife with a special interest in nutrition,
>>>breastfeeding and neonatal metabolic adaptation  in the first days
>>>postnatal.  I am currently finalising data analysis and writing up a
>>>pilot study of a mother baby suckling diary that I designed from my
>>>observations of mothers and babies.  I piggybacked this study onto a
>>>medical RCT of metabolic adaptation  and breastfeeding the moderately
>>>preterm but healthy infant.  The results of the medical bi-centre study
>>>will be published shortly.  Needless to say, they speak brilliantly well
>>>for breastfeeding.  Healthy preterm  infants can be exclusively or
>>>almost exclusively  breastfed and contrary to previous received  ideas,
>>>when healthy but preterm or SGA infants are exclusively  or almost
>>>exclusively breastfed, like healthy term infants, they generate ketone
>>>bodies as a counter-regulatory response to  low blood sugar
>>>concentrations.  Ketone bodies are an alternative  fuel for the neonatal
>>>brain.  The study also highlights that assessment skills is a midwifery
>>>priority.
>>>
>>>I am finishing an MSc in Midwifery studies.  For my dissertation I am
>>>writing up the background and the supporting physiology of a midwifery
>>>mother/baby assessment tool from a biological perspective.   Again I
>>>have designed this tool from observations of early mother/baby
>>>interactions combined with the physiological evidence.
>>>
>>>I would very much like to present this assessment tool (and the
>>>mother/baby suckling diary) at the the joint Perinatal Society of Aus. &
>>>NZ/ Neonatal Nurses
>>>conference in Brisbane and wish to send an abstract to Joan.
>>>
>>>However, before I send my abstract I feel a need to discuss sponsorship
>>>in an open forum.
>>>
>>>I find myself in a real muddle about sponsorship.  And thank you Alice
>>>Campbell for raising this issue in the first place.
>>>
>>>Who would have ever thought that "Clinical Meeting Service" was owned by
>>>Wyeth Pharmaceutical?   This is a typical example of commercial ploys to
>>>hide ownership and makes me feel vulnerable and exploited.   I often
>>>feel  politically  gauche anyway.  In fact sometimes I think it is too
>>>much to ask a midwife to be 'with women' and politically  knowledgeable
>>>and correct.  Yet our choices and knowledge inform  mother's choices.
>>>We have an increasing responsibility to be consciously equipped to deal
>>>with the hidden messages of more subtil advertising.
>>>
>>>I abhor the arrogance and greed of the breastmilk substitute
>>>manufacturers.  Even  in developed countries, when they advertise that
>>>they are experts in infant feeding, they undermine mothers and mother
>>>knowledge.
>>>Although I do not consider them 'the experts' in infant feeding, it is
>>>important to point out that very preterm infants who do not have any
>>>feeding reflexes, i.e., < 32-34/weeks gestation and whose mothers for
>>>any number of reasons cannot or do not want to provide expressed
>>>breastmilk,  will benefit from small amounts of breastmilk substitute.
>>>
>>>Obviously a better solution would be milk banking but this is not
>>>happening everyhere.
>>>
>>>Practically speaking,  it is extremely difficult to organise a
>>>conference, and to make it affordable.   I for one would love the
>>>opportunity to exchange research ideas  in this obvious academic
>>>environment.  I agree with Joan that it would be disappointing  if
>>>midwives chose to boycott the conference because of murky ethical
>>>issues.
>>>
>>>My questions to Joan:
>>>1. Did you know at the time  of booking/ initial organisation  that
>>>clinical meeting service was a subsidiary of Wyeth
>>>2.  Why is Wyeth doing it for free ?  Are they giving out goodies
>>>advertising breastmilk substitutes ?  Are any logos for breastmilk
>>>substitutes on display at congress.
>>>
>>>And general questions:
>>>
>>>1.  How can we escape the negative effects of advertising  and
>>>conglomerate linking of resources for financial gain and greed ?
>>>
>>>2.  Isn't  one way to be more aware of when it is appropriate to use
>>>small amounts of breastmilk substitute and when it is not ?
>>>
>>>I think we need to be crystal clear concerning the majority of instances
>>>when breastmilk substitute is completely inappropriate.
>>>
>>>If following my poster presentation at the Congress, one
>>>midwife/neonatal nurse changes her practice or questions the value of
>>>routinely inserting an NG tube and giving 3 hourly force feeds (gavage
>>>feeds) of breastmilk substitute  to a healthy  but moderately preterm
>>>baby, then maybe the benefits would outweigh the drawbacks of
>>>sponsorship.
>>>
>>>So what to do?
>>>
>>>
>>>Warm regards,
>>>
>>>Suzanne Colson
>>>
>>>
>>>
>>
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