I am wondering what others do in the first few days for non latching
babies.  Do you use both hand expression and pumping or just one or the
other?  We tend to use both, but I find it very time consuming for mother
(and lactation) to try to latch,then hand express (which sometimes takes 10
minutes to get a teaspoon), then alternative feed baby,then pump. This
whole process can take nearly an hour.  Then back to skin to skin and
repeat.  Do others skip the pumping process?  Does using a electric breast
pump encourage more third spacing and edema in the areola? Or does hand
expression?  Does hand expression provide adequate nipple stimulation?

I am seeing a large amount of jaw clenching in newborns lately.  The new
resuscitation  guidelines in the U.S. now state not to routinely suction
infant's airway at delivery.  It is about time.  Still, I don't think the
recommendations have taken hold with the birth attendants.

Thank you for your input,

Mary Westra RN, IBCLC

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