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Breastfeeding: How to succeed
lion and ectopic pregnancy are covered, providing useful information on the causes and therapies available. Such controversial topics as in vitro fertilization, surrogate mothers, and embryo transfer are presented. Medical, legal, and emotional aspects of these issues are alluded to, with the primary focus being a descriprion of the procedures themselves in simple, yet technical detail. Also included is a chapter on sex preselection in which various methods are analyzed. One of the authors then describes in detail his discovery of a technique of sperm separation that increases the likelihood of parents bearing sex of the child they prefer. The final chapter is devoted to questions and answers most commonly asked regarding several different aspects of achieving and maintaining pregnancy. For those unfamiliar with the basics of reproductive physiology, there is an appendix that gives the reader the necessary background for understanding the rest of the book. I think this volume is an excellent resource to recommend to anyone seeking information about a fertility problem or to any health professional who wishes to enhance his/her knowledge of advances in this area. The authors accomplish their purpose in providing brief, practical, upto-date facts in this rapidly changing area, evaluating some common treatments, and presenting alternatives to interested couples.
Signs and Symptoms in Disorders of Pregnancy. Edited by Edward H. Bishop and Robert C. Cefalo. Philadelphia: J. B. Lippincott and Co., 1983. 187 pages. $29.50, hardcover. Reviewed by: A. E. Arkin, CNM, MS The use of differential diagnosis is the central theme of this text that addresses complications in pregnancy. Organized by body systems, the content briefly outlines the normal physiologic changes seen as a result of pregnancy, then examines abnormal developments that may occur in that system. In some chapters, such as the musculoskeletal system, common symptoms such as back pain are presented, followed by the diagnostic investigation into possible causes. In others, ie, the endocrine chapter, specific syndromes, such as Cushing's disease, and their symptomatology are reviewed. This inconsistency of approach to the material produces a somewhat erratic effect for readers.
280
The medical-model approach of the book b e c o m e s most a p p a r e n t in the chapters on psychiatric disorders and substance abuse. In discussing common psychological adjustments, there is no mention of the work of Reva Rubin on the psychological tasks of pregnancy. Instead, the chapter focuses on the pregnant woman's emotional lability, fears of motherhood, and anxiety about the labor and birth experience. Accordingly, the psychological assessment uses the traclitional tools of counting back by sevens, presence of hallucinations or delusions, and interpretation of proverbs. There is no acknowledgement of the less than psychotic maladjustments that can arise, predisposing a woman or family to child abuse. The material is concisely and clearly written. There is, however, little emphasis on the physiologic mechanisms of the disorders--only the clinical picture that they present is given. Therefore, this is not to be considered a basic text in the complications of pregnancy, but could be useful as a review resource for the CNM already in practice.
Breastfeeding: How To Succeed. By Derek Llewellyn-dones, OSE, MD, MAO, FRCOG. Winchester, MA: Faber and Faber, Inc., 1983. 188 pages. $14.95, hardcover; $5.95, softcover.
Reviewed by: Peggy Murray, RN, MN, Clinical Educator-Postpartum, Sharp Memorial Hospital, San Diego, CA. An increasing number of new mothers are choosing to breastfeed their babies. The desire and enthusiastic efforts of some mothers to do so, however, may be hampered by their lack of knowledge about lactation and their lack of skills in the techniques of breastfeeding. To meet the needs of these mothers, Dr. Llewellyn-Jones has written a comprehensive and practical book for laywomen who are interested in effective breastfeeding. It is well researched and well documented; a question and answer section included in this work was derived from an extensive telephone survey of nursing mothers in Australia. The tone of the book is both positive and reassuring, and provides medically sound, in-depth information on a wide range of breastfeeding issues. The book is divided into two parts-one on prepararion for breastfeecling, the other on questions that breastfeeding mothers ask. The first part briefly dis-
cusses the process of lactation and explains the mechanics and techniques of breastfeeding in an easy-to-read format. Topics such as breast and nipple preparation, benefits of breastfeeding for both mother and baby, and initiation of lactarion are treated in detail. The section on anatomy of the breast and physiology of lactation is complex, however, and probably provides more material than the average lay reader could use. Notably lacking, too, is any discussion of the roles of the father and family as support persons for the breastfeeding mother. The question and answer section is arranged alphabetically, and can be useful to the breastfeeding mother, as well as to the lactation educator/health care provider as a quick reference for problem solving. Even though the section is based upon the questions from breastfeeding mothers in Australia, the content is appropriate and seems to reflect the same concerns of breastfeeding mothers in the US. The author also provides a handy reference of equivalent US-British terms and a list of international breastfeeding organizations. Although this is a very helpful book, it has several limitations. The illustrations depicting breastfeeding posirions--a critical item in lactation education--are of poor quality and show the mother inaccurately holding the baby, in a prone position rather than turned to the side toward the breast. These illustrations provide little guidance for the mother and, if imitated, may result in poor latching on. Furthermore, the author advocates the use of nipple shields for fiat nipples, and the use of ice packs for engorged breasts. Each of these practices is losing support in the US. Regardless of these limitations, I would not hesitate to recommend the book as an additional reference to breastfeeding mothers who desire more detailed informarion on a variety of breastfeeding issues than is usually available in breastfeeding pamphlets and brochures. Ideally, the book would be read prenatally and utilized postnatally as a resource. Childbirth educators, maternity nurses, and nurse-midwives could also utilize the question and answer section as a reference for patient teaching and problemsolving. The Littlest Baby: A Handbook for Parents of Premature Children. By Fred R. Pfister and Bernard Griesemer, MD. En-
Journal of Nurse-Midwifery • Vol. 29, No. 4, July/August 1984
Signs and Symptoms in Disorders of Pregnancy. Edited by Edward H. Bishop and Robert C. Cefalo. Philadelphia: J. B. Lippincott and Co., 1983. 187 pages. $29.50, hardcover. Reviewed by: A. E. Arkin, CNM, MS The use of differential diagnosis is the central theme of this text that addresses complications in pregnancy. Organized by body systems, the content briefly outlines the normal physiologic changes seen as a result of pregnancy, then examines abnormal developments that may occur in that system. In some chapters, such as the musculoskeletal system, common symptoms such as back pain are presented, followed by the diagnostic investigation into possible causes. In others, ie, the endocrine chapter, specific syndromes, such as Cushing's disease, and their symptomatology are reviewed. This inconsistency of approach to the material produces a somewhat erratic effect for readers.
280
The medical-model approach of the book b e c o m e s most a p p a r e n t in the chapters on psychiatric disorders and substance abuse. In discussing common psychological adjustments, there is no mention of the work of Reva Rubin on the psychological tasks of pregnancy. Instead, the chapter focuses on the pregnant woman's emotional lability, fears of motherhood, and anxiety about the labor and birth experience. Accordingly, the psychological assessment uses the traclitional tools of counting back by sevens, presence of hallucinations or delusions, and interpretation of proverbs. There is no acknowledgement of the less than psychotic maladjustments that can arise, predisposing a woman or family to child abuse. The material is concisely and clearly written. There is, however, little emphasis on the physiologic mechanisms of the disorders--only the clinical picture that they present is given. Therefore, this is not to be considered a basic text in the complications of pregnancy, but could be useful as a review resource for the CNM already in practice.
Breastfeeding: How To Succeed. By Derek Llewellyn-dones, OSE, MD, MAO, FRCOG. Winchester, MA: Faber and Faber, Inc., 1983. 188 pages. $14.95, hardcover; $5.95, softcover.
Reviewed by: Peggy Murray, RN, MN, Clinical Educator-Postpartum, Sharp Memorial Hospital, San Diego, CA. An increasing number of new mothers are choosing to breastfeed their babies. The desire and enthusiastic efforts of some mothers to do so, however, may be hampered by their lack of knowledge about lactation and their lack of skills in the techniques of breastfeeding. To meet the needs of these mothers, Dr. Llewellyn-Jones has written a comprehensive and practical book for laywomen who are interested in effective breastfeeding. It is well researched and well documented; a question and answer section included in this work was derived from an extensive telephone survey of nursing mothers in Australia. The tone of the book is both positive and reassuring, and provides medically sound, in-depth information on a wide range of breastfeeding issues. The book is divided into two parts-one on prepararion for breastfeecling, the other on questions that breastfeeding mothers ask. The first part briefly dis-
cusses the process of lactation and explains the mechanics and techniques of breastfeeding in an easy-to-read format. Topics such as breast and nipple preparation, benefits of breastfeeding for both mother and baby, and initiation of lactarion are treated in detail. The section on anatomy of the breast and physiology of lactation is complex, however, and probably provides more material than the average lay reader could use. Notably lacking, too, is any discussion of the roles of the father and family as support persons for the breastfeeding mother. The question and answer section is arranged alphabetically, and can be useful to the breastfeeding mother, as well as to the lactation educator/health care provider as a quick reference for problem solving. Even though the section is based upon the questions from breastfeeding mothers in Australia, the content is appropriate and seems to reflect the same concerns of breastfeeding mothers in the US. The author also provides a handy reference of equivalent US-British terms and a list of international breastfeeding organizations. Although this is a very helpful book, it has several limitations. The illustrations depicting breastfeeding posirions--a critical item in lactation education--are of poor quality and show the mother inaccurately holding the baby, in a prone position rather than turned to the side toward the breast. These illustrations provide little guidance for the mother and, if imitated, may result in poor latching on. Furthermore, the author advocates the use of nipple shields for fiat nipples, and the use of ice packs for engorged breasts. Each of these practices is losing support in the US. Regardless of these limitations, I would not hesitate to recommend the book as an additional reference to breastfeeding mothers who desire more detailed informarion on a variety of breastfeeding issues than is usually available in breastfeeding pamphlets and brochures. Ideally, the book would be read prenatally and utilized postnatally as a resource. Childbirth educators, maternity nurses, and nurse-midwives could also utilize the question and answer section as a reference for patient teaching and problemsolving. The Littlest Baby: A Handbook for Parents of Premature Children. By Fred R. Pfister and Bernard Griesemer, MD. En-
Journal of Nurse-Midwifery • Vol. 29, No. 4, July/August 1984