Nikki writes:
<What
about risk for preterm labor?>
That was the medico-legal reason for waiting till 37 weeks gestational
age. A baby born at 37 weeks, providing the dates were correct, is no
longer considered technically premature.
< I know that nipple stimulation during pregnancy is
usually okay (as in lovemaking) but that isn't as much as the hour a day
described here. Did this mother notice an increase in contractions?>
The mother was instructed to be alert for contractions, and to slack off
the pumping if they seemed to be uncomfortable or lasting over 30 seconds
consistently, since we had no desire to actually induce labor. I do not
remember her having any particular problem with contractions.
The 15 minute timing was chosen as an upper limit from two references.
One was an old, old Egnell ad which described this very treatment being
in fairly common use in Europe 50 or so years ago. (If any of our
European Lactnetters can locate this reference, I would love to have it.)
The other reference was a 25+ year old Israeli report on deliberate
induction of labor, using an electric breast pump on one breast for 15
minutes, with a 15 minute rest, and a 15 minute pumping period on the
opposite side, continuing to alternate with a 15 minute rest period.
I believe the shortest time before labor began (or it may have been until
delivery, I can't remember) was 4 hours. The patients were all grand
multiparas whose uteri were all too sensitive to attempt pitocin
induction (which was not very sophisticated or well researched then as it
seems to be now.)
Given her gestational age and the goal of facilitating the breastfeeding
experience in a very unusual situation, the recommendation of four 15
minute periods of double pumping separated by rest periods of 4-5 hours
or so, for this primigravida, with instructions to observe for
contractions, seemed like a reasonable and safe thing to offer her. The
ultimate choice to do it or not was the mother's.
Interestingly, there was little or no colostrum sacrificed. But, as in
the Israeli study, after delivery, "there was an early onset of a copious
milk supply with little or no engorgement."
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA
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