>I made a statement about pumping after birth a few days ago. Since then, I
>have noticed a large number of responses. I think my original message about
>pumping in the first hour after birth was COMPLETELY misunderstood and I
>would like to clarify this.
>
>A IBCLC colleague of mine came back from a conference once having learned
>about the colostrum bolus that is present in that first hour. After that time,
>we initiated pumping for ANY mom whose baby would do absolutly nothing in
>the way of nursing, latching or anything in that first hour or two.
Thanks for clearing this up, Betsy....seems I did understand
correctly first time!
I understand the desire to support breastfeeding, but bringing in a
new intervention at this precious 'getting to know you' stage of the
breastfeeding relationship is something that surely needs careful
thought. Someone comes back from a conference with a message about a
bolus of colostrum - this may be useful knowledge which helps us
understand more about the importance of early bf. But I am puzzled
about how this can justify a change in the management of early bf.
Giving a pump to a mother is an intervention.
We have - haven't we? - learnt enough about the downsides to any
intervention to be very wary of them. You change something - and
something else may change as a result that you never even thought
about.
Maybe this intervention with the pump makes more mothers *less*
confident in their breastfeeding. Maybe it means less breastfeeding,
long term, than more. I don't know. It's something that would need to
be followed up and evaluated.
Maybe in certain settings it really does make a positive difference
- does this balance out any negative effects?
I don't have to outline how to evaluate something, I am sure, but
I'd put in a plea for evaluating how the mothers feel about it. Is it
empowering to them? Or do they feel more worried?
> I am not sure why this generated so much
>conversation about how baby should really be at breast, etc,. I was speaking
>only about the extenuating circumstances that sometime occur. That is all.
It created conversation because it is an intervention - and
intervening, while sometimes essential, is a big deal.
I can envisage Rachel Myr's dystopian scenario of the bolus being
measured and assessed - this is exactly what happens when we start to
do this sort of messing about. We have to recognise the risks of it.
Babies and mothers, and yes, the non-latchers and the non-lickers,
the 'clueless' babies as you put it, need to be together, in close
physical contact ad lib.....it could well be that when this happens,
the non-latchers and the non-lickers reduce in number and by not
intervening, we support the gentle start to their relationship with
their mother.
Heather Welford Neil
NCT bfc, tutor, UK
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