Karleen has been asking such wonderful questions.  Wish I had tiem to
digest this information into a clearcut format - it would make a nice book
on how and when to use supplementing devices on the breast and when not to!!
Another project I'd love to do, but don't have time for - at least not yet.

So... catching up on all her postings -

She stated:

"I often wonder about the usefulness of breastfeeding supplementers. The
places where we have the most studies on relactation (and the most
women...the Indian study frm last year with 1000 women for eg!) have not had
any gadgets at all, no pumps no supplementer and have just concentrated on
breastfeeding and supplement after breastfeeds."

So, I've been pondering the differences between the population I and my
colleagues see and the India population.  The population we see is
predominantly primips, typically older women, I'd say 15-20% have fertility
problems (some of those with PCOS).  Often, there has been some
interference in stimulation of the supply while in the hospital.  I have
seen two women that got a kick out of handexpressed - most of the rest will
do it for a while, but are not truly comfortable with it.  How many of the
women in the India study had achieved full lactation with a previous
child?

Another question Karlene asks is:
"but just how useful are they in cases where mothers are concentrating on
increasing milk supply??"

The answer to this is variable.  That's why I always check milk transfer
with the device.  I had one baby take 5.6 oz from the breast with the small
tube SNS in place and 2.0 oz from the SNS.  This was an exceptional case
because we caught the baby at 6 weeks, 4 oz above birth weight.  The baby
had frank marasmus - as obvious as any baby I'd seen back when I was
working in International Nutrition.  And that avid hunger that led her to
take in 7.6 oz, also promptly led to the obvious - a copious upchuck.  But
she was completely unfazed and looked quite satisfied after that ravenous
feed and did slow down once she got it that she could get enough to satisfy
herself.

I've had some babies who take nothing from the breast and then I look to
why they aren't able to transfer from the breast and often will adopt other
strategies - or use the SNS to get some breast time in if the baby isn't
latching.


Best, Susan Burger, MHS, PhD, IBCLC

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