Hi all,
I am very interested in the posts about the colostrum bolus. It would be quite rare for me to see 10-15 ml during the first 24 hours or even 48 hours of expressing. I generally start the mothers pumping as soon as possible if expressing is definitely indicated, for example in a preterm birth. Today I had a mother whose baby could not latch (tongue-tie) and she began pumping at about 9 hrs, after first trying postions, skin to skin, etc. She got maybe 1-2 mls. Previous to this, she and I had hand expressed but only got drops. We have the Hollister/Ameda Elite pumps. When I worked in New Orleans, we used the Hollister SMB pumps, but I found no difference. I wonder if the poster who sees the larger volumes in 50% of her cases generally starts mothers pumping later, like after 12-24 hours, like it sounded she did. This would be quite interesting, because one might harvest more colostrum by waiting 24 hrs, and this would be ok if baby was not going to be fed before then. This is counter-intuitive though. I do agree that the amount a mother gets is often larger with the first expression, and smaller for the next few times, and then starts to build up in volume. I do let mothers know that this is likely.
I'll tell you something else: I am using the largest flange size in most cases now, which I feel is yielding greater volumes, and I am having the mother cover up and try distraction, instead of looking at those flanges and bottles, which I feel does help with the letdown.
Re the large flange sizes, one mother was getting 20 mls each pumping. I changed her to the large size, even though she did not look too tight in the normal size (yes, checked during pump use) and she immediately got 1.5 oz each side.
Laurie Wheeler, IBCLC, MN, RN Mississippi, s.e. USA
_________________________________________________________________
Get the new Windows Live Messenger!
http://get.live.com/messenger/overview
***********************************************
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]
The LACTNET email list is powered by LISTSERV (R).
There is only one LISTSERV. To learn more, visit:
http://www.lsoft.com/LISTSERV-powered.html
|
