Hi all
 
It has never occured to me that I should suggest to mothers not hand express
colostrum  during pregnancy.  The are several reasons why.
 
Firstly - colostrum is best hand expressed.  It is my understanding that
pumping is very inefficent way to express colostrum.  Hand expressing
results in far more colostrum.  After baby is born, if they are not going
and suckling at the breast for any reason, we always hand express where I am

 
Secondly - the idea of starting contractions due to expressing makes no
sense to my way of thinking.  Mother's who end up tandem feeding up to birth
and beyond do not have premie babies unless it was going to happen anyway. 
Another way to put it is that breastfeeding an older baby/toddler or hand
expressing colostrum is not the reason for premie babies anymore than tandem
feeding the cause of miscarriage.
 
Thirdly - why was this mum experiencing pain in the early days of feeding? 
What was the attachment like?  What were the labour interventions that
resulted in baby being unable to attach or suckle effectively?  What were
the baby issues that resulted in poor attachment - tongue tie? Palate
problems etc?  Does mum have issues with breastfeeding that need to be
explored e.g. Rape or abuse, low pain thresh holds etc?
 
It would be interesting to see what the difference in blood oxytocin levels
are between hand expressing colostrum pre birth, orgasm in the late stages
of pregnancy and oxytocin levels in labour.  We know that the the baby
actually initiates labour - but I do not know of studies that look at the
trends of oxytocin during labour e.g. How much oxytocin is at the beginning,
and end - if and when are there surges in oxytocin?
 
 
Ruth Fiedler
Australia
 

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