susan says,

<< I agree that direct breastfeeding is best...however: What about moms who
 choose to work?  I was taught a long time ago that before returning to work
 a woman should get a "running start" on her supply so she can relax that
 first week back or so. I know most moms have too much milk at first...and
 that babies "catch up" with supply around two weeks (usually.) For a mom
 that is returning to work...storing this milk is good insurance that she
 will not need ABM. >>

i fail to see how a mother's milk supply can become balanced with her baby's
needs if she is pumping. i strongly discourage mothers from pumping in the
early weeks unless there is a problem, because this merely adds stress to
their routine. it also makes mothers feel there should be a routine schedule,
as in "i just pumped, the baby can't nurse for two hours, i am empty," etc.
just because we have a ridiculous standard of returning to work so quickly in
this country, does not mean we should cater to it, as health professionals.

i tell mothers that they need to rest and get breastfeeding well-established
before they begin pumping for a return to work. pumping during the first two
weeks should only happen when the baby is not breastfeeding well and the
mother *must* pump to support her milk supply and feed the baby. as jack
would say, fix the breastfeeding first.

i think pamela's account of how the pumping scenario works in zimbabwe is
fascinating, and i think it reflects how things are so totally the opposite
of here in the US. i often see a mom who i supplementing with ABM because she
started out with pumped milk (or not), thinking her baby was not getting
enough  to eat, and she is continuing to do so for a long time. doctors feed
that illusion by giving a mom a can of formula and saying "you have to
supplement after each nursing session" whenever they think they see a
problem. of course, where you are, breastfeeding is the norm, and here it is
not. i thnk that is the explanation.

lucky you, pamela!

carol brussel IBCLC
laura nevada lactation
www.breastfeedinghelp.com

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