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Drug use in pregnancy
their infant, as well as ventilate their own thoughts and feelings. The next section of the text deals briefly with the advantages of breastfeeding a pretenn infant. This section, unfortunately, is not referenced. This reviewer feels that on many occasions breastfeeding couples encounter hostile forces in ICNs. They need to be armed with solid documented facts to support their choice of feeding. Formula supplementation is described next if “a premature breastfed baby is gaining too slowly . . . .” Various types of supplementation are presented. Gavage and intravenous feedings are also defined and discussed. Unfortunately, there is no discussion of the very real possibility of “nothing by mouth” as part of the treatment for necrotizing enterocolitis (NEC). “The incidence of NEC varies from 2-15 percent of admissions in ICNs . . . clinical care involves NPO and intravenous alimentation.“’ This unforeseen complication and its implications may be very distressing to parents or to mothers who are encouraged to pump, feed, and supplement in the ICN. The information about breastfeeding in this publication is truly excellent. Different pumping techniques, positioning, feeding hints, common problems, pitfalls, solutions, nutritional advice and much more are presented vey concisely and clearly. The problems are described as simply something that can be overcome and the couple is given constant, although subtle, encouragement. Various pictures are incorporated to aid in the explanations. The text also supplies the mother with a sample record chart to aid her with pumping, feeding, and caring for her baby. The chart is straightforward, but a note of explanation of its use and possible misuse by the couple would be helpful. A resource list that provides the parents with additional support, information, and pumping supply locations is at the end. Although most of the information is common knowledge to CNMs, this booklet can be a quick reference for any CNM counseling a breastfeeding mother of a premature infant. When the CNM recommends this booklet for couples, she should fill in missing information, such as references on breastfeeding and NEC, if and when it becomes necessary for that particular couple. Breastfeeding Your Premature or Special Care Baby will be of great assistance to a couple breastfeeding a preterm infant. The pub238
lication gives much information that will help a mother to successfully breastfeed her preterm infant.
REFERENCE 1. Klaus M, Fanaroff A: Care of the high risk neonate. Philadelphia, W.B. Saunders, 1986, pp 137-139. Drug Use in Pregnancy, Second Edition. Edited by Jennifer R. Niebyl, MD. Philadelphia: Lea and Febiger, 1988. 245 pages. $29.90, hardcover. Catalog of Teratogenic Agents, Fifth Edition. By Thomas H. Shepard, MD. Baltimore: The Johns Hopkins University Press, 1986. 710 pages, $45.00, hardcover. Reviewed by: Tom Lloyd, MS, CNM, Assistant Professor, Nurse-Midwifery/ Women’s Health Care Program, Oregon Health Sciences University, Portland, Oregon. Drug Use in Pregnancy is a collection of 19 monographs authored and coauthored by 22 individuals. The principle author and editor is the director of the Division of Maternal-Fetal Medicine at Johns Hopkins University School of Medicine. The book contains 19 chapters categorized according to clinical use (and abuse) of a class of drugs. Most of the chapters provide a detailed perspective of the use of drugs in the management of particular health care problems during pregnancy (e.g., “Antibiotics in Pregnancy, .” “The Use of Anti-Asthmatic Drugs in Pregnancy; ” “Anticoagulants in Pregnancy”). Also included are chapters on the abuse of alcohol, tobacco, narcotics, marijuana, cocaine, and caffeine. The book concludes with a brief chapter on “Treatment of the Common Cold in Pregnancy.” The book is clear, concise, and lends itself easily to quick perusal of the given topics. Each chapter is broken down into clearly labeled subsections, which facilitates rapid reference. Most chapters provide an overview of pathology and an itemized discussion of particular pharmacologic agents. There is liberal (yet crucial) documentation of the scientific literature with regard to the actions and side effects of these agents, as well as their teratogenic potential. Each chapter ends with an easily readable reference list. Most of the information in thii book is Journal
of Nurse-Midwifery
l
readily available in other, more general texts; however, to obtain the same amount of specific information as included in this book, one would have to use both a general text and a pharmacologic one. Even then, most pharmacologic texts do not reference the clinical literature (as opposed to the theoretical and experimental) as completely as this book. Catalog of Temtogenic Agents is a collection of nearly 1500 abstracts pertaining to the teratogenic potential of commercial pharmacologic agents, naturally occurring substances (e.g., locoweed, hemlock, snake venom), pathogenic agents, and physiologic conditions (e.g., myasthenia gravis, zinc deficiency, hyperthyroidism). The entries are listed alphabetically and range from “Abortion, Induced’ to “Zopiclone.” The author is a faculty member of the Department of Pediatrics (Central Laboratory for Human Embryology) in the School of Medicine at the University of Washington. Most of the book’s entries provide information about a single, well-defined agent, although some entries include information on a class of agents. For example, the entry “Solvents, Organic,” includes data on at least twelve substances. Commercial pharmaceutical agents are listed under both the generic and trade names. The abstract, however, is listed only under the former. Some related topics are included under more than one listing, but they are adequately cross-referenced. For example, there are separate liitings for “Hyperthermia” and “Sauna Bathing” (which includes a reference on hot tubs). The catalog presents only the findings of scientific studies and case reports regarding the teratologic evidence. With a few exceptions, there is almost no interpretative discussion. This lack of speculation, although an asset, assumes that the reader is capable of making his or her own cautious interpretation of the often inconclusive literature. Almost all the abstracts are less than half a page. A complete reference list is included at the end of each abstract. Both of these books are welcome additions to any nurse-midwife’s library. Each lends itself easily to the type of quick reference demanded by the busy practitioner. There are, however, some very minor weaknesses in both books. Neither book uses the Food and Drug Vol. 33, No. 5, September/October 1988
lication gives much information that will help a mother to successfully breastfeed her preterm infant.
REFERENCE 1. Klaus M, Fanaroff A: Care of the high risk neonate. Philadelphia, W.B. Saunders, 1986, pp 137-139. Drug Use in Pregnancy, Second Edition. Edited by Jennifer R. Niebyl, MD. Philadelphia: Lea and Febiger, 1988. 245 pages. $29.90, hardcover. Catalog of Teratogenic Agents, Fifth Edition. By Thomas H. Shepard, MD. Baltimore: The Johns Hopkins University Press, 1986. 710 pages, $45.00, hardcover. Reviewed by: Tom Lloyd, MS, CNM, Assistant Professor, Nurse-Midwifery/ Women’s Health Care Program, Oregon Health Sciences University, Portland, Oregon. Drug Use in Pregnancy is a collection of 19 monographs authored and coauthored by 22 individuals. The principle author and editor is the director of the Division of Maternal-Fetal Medicine at Johns Hopkins University School of Medicine. The book contains 19 chapters categorized according to clinical use (and abuse) of a class of drugs. Most of the chapters provide a detailed perspective of the use of drugs in the management of particular health care problems during pregnancy (e.g., “Antibiotics in Pregnancy, .” “The Use of Anti-Asthmatic Drugs in Pregnancy; ” “Anticoagulants in Pregnancy”). Also included are chapters on the abuse of alcohol, tobacco, narcotics, marijuana, cocaine, and caffeine. The book concludes with a brief chapter on “Treatment of the Common Cold in Pregnancy.” The book is clear, concise, and lends itself easily to quick perusal of the given topics. Each chapter is broken down into clearly labeled subsections, which facilitates rapid reference. Most chapters provide an overview of pathology and an itemized discussion of particular pharmacologic agents. There is liberal (yet crucial) documentation of the scientific literature with regard to the actions and side effects of these agents, as well as their teratogenic potential. Each chapter ends with an easily readable reference list. Most of the information in thii book is Journal
of Nurse-Midwifery
l
readily available in other, more general texts; however, to obtain the same amount of specific information as included in this book, one would have to use both a general text and a pharmacologic one. Even then, most pharmacologic texts do not reference the clinical literature (as opposed to the theoretical and experimental) as completely as this book. Catalog of Temtogenic Agents is a collection of nearly 1500 abstracts pertaining to the teratogenic potential of commercial pharmacologic agents, naturally occurring substances (e.g., locoweed, hemlock, snake venom), pathogenic agents, and physiologic conditions (e.g., myasthenia gravis, zinc deficiency, hyperthyroidism). The entries are listed alphabetically and range from “Abortion, Induced’ to “Zopiclone.” The author is a faculty member of the Department of Pediatrics (Central Laboratory for Human Embryology) in the School of Medicine at the University of Washington. Most of the book’s entries provide information about a single, well-defined agent, although some entries include information on a class of agents. For example, the entry “Solvents, Organic,” includes data on at least twelve substances. Commercial pharmaceutical agents are listed under both the generic and trade names. The abstract, however, is listed only under the former. Some related topics are included under more than one listing, but they are adequately cross-referenced. For example, there are separate liitings for “Hyperthermia” and “Sauna Bathing” (which includes a reference on hot tubs). The catalog presents only the findings of scientific studies and case reports regarding the teratologic evidence. With a few exceptions, there is almost no interpretative discussion. This lack of speculation, although an asset, assumes that the reader is capable of making his or her own cautious interpretation of the often inconclusive literature. Almost all the abstracts are less than half a page. A complete reference list is included at the end of each abstract. Both of these books are welcome additions to any nurse-midwife’s library. Each lends itself easily to the type of quick reference demanded by the busy practitioner. There are, however, some very minor weaknesses in both books. Neither book uses the Food and Drug Vol. 33, No. 5, September/October 1988