Kika said,
We are designing a study to compare colostrum volumes at different times.
We decided to study this because in our clinical experience in a
birthing/postpartum/maternity ward, volumes of expressed colostrum are
surprisingly LARGE during the first two hours after birth, and then that
bounty seems to diminish.>>
I have been convinced of this for several years. It is related to the oxytocin influence on the myoepithelial cells during the birth process -- Donna Geddes talked about this a number of years ago. What would be fascinating, Kika, is if you looked at the type of birth the mother had and how that relates to the volume of colostrum available -- for example, if she was induced or had a repeat C/Section, I wouldn't expect nearly as much colostrum within that first hour and a half as if she went into labor on her own and had either a normal spontaneous vag delivery -- or even if she ultimately ended up with a C/Section.....I think the going into labor on her own is key since we know that Pitocin can suppress her own oxytocin levels. And would there be a difference between moms who have an epidural and those who don't -- same reason -- suppression of her on oxytocin levels.
I've always thought that here in the US anyway, you would get more colostrum in that hour after birth with pumping rather than hand expression -- I don't know if that is because women don't express to empty, or if they just aren't as skilled at it as they may be later on. But certainly after that first expression, hand expression would be better. Again, another good study in the making....
Jan Barger, RN, MA, IBCLC, FILCA
Wheaton IL, USA
Jan
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There are 3 messages totaling 140 lines in this issue.
Topics of the day:
1. Core Breast Biopsy
2. Hospital IBCLC staffing protocol
3. Colostrum volume
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Date: Sun, 8 Jan 2017 22:50:23 -0800
From: Janet Business <[log in to unmask]>
Subject: Core Breast Biopsy
Hi Carol,
Mostly from personal experience and anecdotes over the last few years. Reducing some supply on the side will help some with pressure/engorgement after procedure. Her emptying breast as close to the procedure will help also. Fistulas are messy, but manageable and the best milk movement through feeding or pumping will help.
Obviously it will also help to know why baby isn't gaining well. Poor intake or low supply?
Janet Dombro, IBCLC
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Date: Mon, 9 Jan 2017 09:23:16 -0500
From: Marsha Walker <[log in to unmask]>
Subject: Hospital IBCLC staffing protocol
The US Lactation Consultant Association has staffing guidelines for the
IBCLC lactation consultant. They include:
Level I hospital = 1.3 FTE per 1000 births
Level II hospital = 1.6 FTE per 1000 births
Level III hospital = 1.9 FTE per 1000 births
See:
http://uslca.org/wp-content/uploads/2013/02/IBCLC_Staffing_Recommendations_July_2010.pdf
AWHONN adopted these guidelines into their "Guidelines for Professional
Registered Nurse Staffing for Perinatal Units." See
http://docplayer.net/503625-Guidelines-for-professional-registered-nurse-staffing-for-perinatal-units.html#show_full_text
AWHONN also recommends that IBCLCs be available 7 days a week.
Marsha Walker, RN, IBCLC
Weston, MA
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Date: Mon, 9 Jan 2017 19:20:55 +0100
From: Kika Baeza <[log in to unmask]>
Subject: Colostrum volume
Hi,
We are designing a study to compare colostrum volumes at different times.
We decided to study this because in our clinical experience in a
birthing/postpartum/maternity ward, volumes of expressed colostrum are
surprisingly LARGE during the first two hours after birth, and then that
bounty seems to diminish.
Our midwives have helped mothers to hand express colostrum in the first two
hours after birth, and volumes have systematically ranged from 25 to 65 ml.
This makes sense, as Nature would want the baby´s gut well protected as
soon as possible after birth... So our hipothesis is that colostrum volumes
are higher and it is smuch easier to express right after birth.
We always use hand expression, preferably done by mother.
The informal prototype protocol that has been in place for a few months
now.
Which moms express their colostrum?: those whose babies have not latched or
have done no effective sucking in the first hour and a half after birth.
Why an hour and a half?: because two hours after birth, mom and baby are
taken to the maternity ward, where baby will be supplemented with formula
if she has not eaten (bad policy, but it´s the one that´s there). *Our*
reign ends after those two hours, if you know what I mean.
Hope this helps and more of you try this out, maybe we can all get a lot of
data!!!
Kika
--
Dra. Carmela Baeza
Médico de Familia
Consultora Certificada en Lactancia Materna IBCLC
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