Angie asks:
 
 
We are  trying to improve how quickly we get a breast pump to moms' bedsides
to  begin pumping for their NICU babies.  Does anyone have any research  other
than the 1998 article by Furman that says within 6 hours?  How  soon do your
policies say that moms should be given a pump?  What is  it based on?  I
greatly appreciate any and all  responses.

 
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Angie,
 
Why is anyone WAITING 6 HOURS (!!!!) to get mom to start  pumping?  They 
should be pumping within the first hour after birth, just as  we put a baby to 
breast within that first hour.  There IS a bolus of  colostrum available to the 
baby who is put to breast -- and there is a bolus of  colostrum available to 
the pump as well.  Do we have a published  study?  NO!!!  Why not?  I've been 
begging for this for several  years now.  Those hospitals that do assure that 
moms pump within the first  hour after birth (there are a few -- not many -- but 
as I travel around I hear  about more and more) find that there is at least a 
10 - 20 ml bolus --  occasionally 30 ml -- and even up to 4 ounces in one 
case and 10 ounces (yes,  ounces!!!) in another case.  
 
The second pumping will not get nearly as much -- but if you wait for 6  
hours, you will get drops around the flange if you are lucky, and it can take up  
to 6 to 7 full pumpings to get much of anything.  Meanwhile, what is our  poor 
little one in the NICU eating if he is ready to eat?  Donor breastmilk  if he 
is one of the few lucky ones in the US -- formula if he isn't.  
 
I am BEGGING for a study to be done on this so we have documentation.
 
Of course, it means that you have a pump in L&D.....think anyone can  manage 
that?  Not to mention teaching the L&D staff how and why this  needs to be 
done.
 
Not yet off my soapbox on this issue:
 
Jan Barger, RN, MA, IBCLC
Lactation Education Consultants.






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