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Thanks, Pat in SNJ

      Hello Everyone,

      Help.  It is very frustrating for me and the nursing mothers I work with to have another lactation consultant teach them something that contradicts what I've told them.

      There are three LCs at Naval Hospital Camp Lejeune who teach "Finish the First Breast First'.  We say the first breast is dinner and the second is dessert. Baby needs to finish his dinner before he can have dessert and dessert is an option.  I tell mothers that if the baby falls asleep at the breast to burp him.  If he wakes up looking for more and the first breast still feels like it hasn't been emptied [still firm/full] then put the baby back onto that breast.  If the baby does not want dessert then she can pump or hand express milk from the second breast but only to comfort and use ice packs for 15-20 minutes after feedings.

      I worked with Betsy Corcory at Virtua and this is what we taught our patients.
      What I've learned from reading and at conferences regarding foremilk/hindmilk, FIL and the prevention and treatment of engorgement keeps me teaching this way.  BUT correct me if I'm wrong.

      The LC in our Post Partum Care Clinic tells moms that when the baby comes off the first breast he is done with that one and to put him on the second.  She is concerned that when the baby only nurses on one breast the second breast will become badly engorged.

      The IBCLC in our Pediatric Clinic recently took the CLC (certified lactation counselor ) course for the CERPs.  She tells moms that there is no such thing as foremilk/hindmilk and therefore they can switch breast as they see fit.  This she got from the CLC program.
      Which is a whole other issue.  I now have CLCs that patients think are IBCLCs.  And my CLCs didn't even learn enough to know a mother needs a double pump set up if you're setting her up to pump. But I digress.

      So Ladies, the LC in the Post Partum Care Clinic is asking me to prove my point. It's not so easy to do when many references say "Finish the First Breast First" but don't go on to explain that point very well.  Somewhere I read, "it is better to nurse well on one breast than to nurse a little on both".  But I can't recall where.  It might be Virtua's Breastfeeding Guide that Betsy wrote?

      I appreciate your feedback.

      Thanks,
      Linda L. Bubeck LPN, IBCLC, RLC
      843-495-0554 cell phone
      910-450-4293 office
      Naval Hospital at Camp Lejeune 


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