Karleen said:
 
<<But Righard's research  found that it took an *average* of 50 minutes for
babies to attach??? That's  a lot that took more than an hour unless the SD
was very samall (can't find  the damn paper in the pile!)
It seems to me that taking the baby away and  handing the mum a pump after an
hour is a very bad  idea.>>


 
Wow, what a LOT of  misunderstandings!!  First of all, it is 55 minutes, + or 
- 4 minutes to  the first latch according to the research (Righard & 
Widstrom).  I'm  not sure ANYONE suggested taking the baby away and handing the mom a 
pump in the  first hour.  Of COURSE that is a bad idea.  
 
Secondly, I think all of us that  are advocating pumping within the first 
hour to capture that bolus of colostrum  are talking about pumping ONLY when the 
baby is UNABLE to breastfeed -- i.e. has  been whisked away to the NICU for 
whatever reason.  We are NOT talking  about a normal, healthy infant who is 
capable of being put skin to skin and wait  it out.  We ARE talking about that 
baby (like the one I saw two days ago  that is in the NICU, and has been in the 
NICU for the past 4 days.  No one  offered this mom a pump until 12 hours 
postpartum.  Why not?  She had  a C/Section.  She couldn't get to the NICU to 
breastfeed immediately.   She couldn't do STS -- the baby was in distress.  And 
when baby could feed,  he got formula because there wasn't any expressed 
breastmilk available and mom  couldn't get to the NICU for every feed yet).  C'mon 
guys, we need to look  at what we are talking about here.  
 
Someone asked about when to start  pumping for moms who can't breastfeed -- 
was there documentation about 6 hours,  and I said we should start pumping for 
those babies within that first hour after  birth to capture that bolus of 
colostrum (and gave an example), and the posts  from there went zonky!  Everyone 
that thinks we are talking about normal  healthy newborns who can stay with 
their mothers completely MISSED THE  POINT!!!
 
The assumption is that an  intervention will be needed because mom and baby 
are separated.  The POINT  IS:  PUMP within that first hour.  Or hand express.  
But GET THAT  BOLUS OF COLOSTRUM so you have something to feed the baby as 
soon as the baby  can be feed instead of waiting, having the bolus shunted back 
up the ductile  tree, and being unable to get anything at 6, 8, 10, 12  hours.
 
I have another mom that had a C/Section.  Baby is 38  weeks.  Weighs 4-12 
(hmmmmm).  Went immediately to the NICU.   When I came in to see mom at about 10 
hours pp, there was no pump in  evidence.  The NICU staff has already told mom 
that she can pump and will  be feeding the breastmilk with fortifier in a 
bottle because "breastmilk only  has 20 calories/ounce" and the baby needs much 
more than that to grow.  
 
Sigh.
 
One more example -- another person who lurks on Lactnet shared  w/ me, and 
told me to share w/ y'all that a mom whose baby went to the NICU  immediately 
after birth asked to pump at 1 - 1 1/2 hours after birth because she  was 
feeling uncomfortable.  She got 10 (that's TEN) ounces!  Now --  unusual?  Of 
course.  But the point is, why are we waiting when we  KNOW the mom is going to have 
to pump -- and why are all these babies getting  formula instead colostrum???
 
Although I resonate with Rachel's post, I too think it was  taken a bit out 
of context....  what's happening in many facilities though  is that if the baby 
doesn't latch on within that first hour, they are shipped  out of L&D and to 
the PP unit, and often the baby is taken to observation  nursery.  So it is 
happening, Rachel -- though not quite yet exactly as you  described.
 
Sorry for the yelling (yes I am), but I do think we need to  READ the posts 
-- go back to the first one and see what the thread is -- before  making 
assumptions that aren't there.  Or ask for  clarification.
 
Jan Barger, RN, MA, IBCLC --  whose daughter was pointed out at church today 
as being the only Bears' fan  there.  (They live in Indianapolis, in what they 
are terming, "a house  divided").  We, of course, are in comfortable Bears  
country....
Wheaton IL (3 1/2 hours until  kickoff).







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