Jennifer, 

I just returned from the Amarillo Conference which focused on the pre-term
infant, including the ELBW infants (very pre-term). Hartmann talked about
infants as young as 22 weeks surviving, which is just over half a normal
gestation. He confirmed that many mothers have trouble initiating a full
supply with a baby coming this early. He talked about the change in milk
components being a marker in these moms for determining when lactogenesis II
occurs. I believe he (or one of the other presenters) said that if these
early moms can get up to 350 ml/day production, the management becomes more
like a term mom.

Many other lactnetters attended, so they may have more to add and better
advice. I didn't jot down any real 'fix' for this from Peter's session. Dr.
Jane Morton also presented, and her philosophy is for these moms to try
everything. She recommends pumping initiation within 6 hours of birth. She
had a great approach to pumping--not just to pump for 15 min, but to pump
til the milk flow stops. Then stop, do manual massage, and pump again to get
the residual. (This assumes the mom's milk has come in). She also showed a
vignette from her video, A Premie Needs His Mother. It looks so very helpful
and inspiring. I hope to get it soon for our hospital.

Hope others have more to share on this...Your friend is fortunate to have
you for emotional support.

Anna Swisher, MBA, IBCLC
Abundant Blessings
Austin, TX

 

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