Nina says,
 
 
<<Since mothers have been expressing their milk by hand for  millennia, I 
think the onus is on your colleagues to show YOU evidence that  the use of a 
breastpump in the hours and days after birth is more effective  (more milk 
available to baby at all time points) than hand expressing.  I  suggest you 
turn this interaction around and take back the power.  Ask  your supervisor 
to provide the evidence in support of her position.  (I  suggest a 
conciliatory approach ... You have obviously read something I  haven't.  Could you 
share it with me?)>>

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Interesting discussion....
 
When I speak at conferences/lecture at courses, I am encouraging  
staff/lactation consultants to have mothers pump within the first hour after  birth 
IF the baby has to go to the NICU (there really really really needs to be  a 
good study done on this!!).  Anecdotally, what we are finding ACROSS THE  
COUNTRY is that if a mom pumps within that first hour, she generally gets an  
average of 20 ml which can then go to the NICU for the baby when he/she is 
ready  for oral feeds.  Some of that depends on if the mom was in labor on 
her  own, if she had a repeat C/Section (no labor) and if she was induced 
(only  artificial oxytocin) -- there are differences in amounts  obtained.
 
Now, when I spoke at one conference and brought this up, one  attendee 
stated they had their moms hand express in the delivery room if the  baby had to 
go to NICU.  They got an average of 5 ml when mom hand  expressed.  The 
attendees in the audience who had their moms use an  electric pump got an 
average of 20 ml.
 
However, later on -- 6 - 8 - 12 hours later, the hand expressers  got more 
than the pumpers.
 
Would love for someone to do a good study on this!!
 
Meanwhile, another shout out to NOT WAIT for 6 hours to start  pumping/hand 
expressing if baby is in NICU.  Start in the delivery room --  within that 
first hour -- DON'T WAIT!!!
 

Jan Barger, RN, MA, IBCLC, FILCA
Lactation Education  Consultants
_www.lactationeducation.com_ (http://www.lactationeducation.com/)   

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