<Is the recommendation to feed on one side for twelve hours?
I am working with a mother with a week-old baby who has been told to
pump (not hand-express) first, every feed, and then feed on one side for
twelve hours because of suspected foremilk / hindmilk imbalance and
overactive letdown. Weight is o.k. Her baby is, as you might expect,
colicky and not sleeping a lot, and she is getting tired. >
ONE WEEK OLD!? For Pete's sake! She is still in the middle of colostrum
transitioning! I have observed colostrum looking very concentrated as the
breast was further pumped after a pumping before nursing, but
foremilk/hindmilk imbalance?? Oh I can just hear the travail from those
who "wish the terminology had never been created!"
And OALD?! At one week? Most mothers, in the US, at least, are just
barely clearing the hurdle of engorgement, leaking is a relief, and
frequent feedings, either both breasts at a feeding or alternating
breasts at hunger cues, are a great comfort source for mother and baby!
Any previous comments I have made on this list were in the context of a
mother with a well established supply, D cup or larger, clearly visible
signs of baby struggling with the rate of the MER, rapid weight gain,
frequent fussiness within 45 minutes after eating, very loudly gassy,
greenish (and sometimes just occasional greenish tinges) explosive
stools, etc.
And even then, my personal recommendation to the mother is to try letting
the baby return to the same breast to receive more concentrated cream
each time the baby wants to eat within a whole morning, or afternoon, or
evening (e.g. a 4-6 hour period.)
I sometimes tell some mothers who are afraid to try this that I had heard
that some agricultural cultures use one side all day and the other all
night, and let her choose for herself if she wants to try this pattern.
I hope that I, too, have not somehow helped in the creation of a
Frankenstein!
Jean
**************
K. Jean Cotterman RNC, IBCLC
Dayton Ohio USA
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