<and my experience is that 4 hour post delivery moms can't pump
that. >
Cathy,
How expert have your nurses become in the Marmet method of fingertip
expression? If you could pick a few volunteers to learn, if they stand
slightly behind and to the side of the mother, it is an excellent way for
them to learn, and also a position I recommend for teaching mothers. If
you are not familiar with the Marmet method there are excellent
instruction sheets available through LLL.
I consider it a valuable self-care skill that can be helpful to all new
breastfeeding mothers. We sometimes just have to get past the cultural
barrier of sexuality that our society has allowed to be superimposed on
it, by explaining that mothers around the world have been learning it for
aeons.
There is much more colostrum present in the sinuses and stored in the
ducts before delivery than we might imagine. (And early removal leds to
earlier and increased production with less engorgement.)
Inward directed, positive pressure applied from the proximal end of the
milk sinus, rippling the entire sinus in the direction of the distal end
is much more effective at this stage (IME) than negative pressure that
pulls primarily on flesh, and might, or might not, depending on the
individual anatomy of the breast involved, cause sufficient compression
of the milk sinus against the inner rim of the pump flange to result in
droplets coming out the nipple (and some will be wasted sticking to the
bottle.).
If fingertip expression at 6:00 and 12:00 positions (IME 1/4 ounce yield
for most mothers), is alternated with 3:00 and 9:00 positions, and this
then alternated with massage, and done for just a few short minutes every
hour or so, I bet most mothers could easily yield a total of 1 ounce
(<450 drops) in a medicine cup within a few hours after birth. It would
certainly be a publishable thing if you were to be able to do this in
practice for a large percentage of mothers on whom it is tried as an
intervention. (I have been retired for 5 years after 44 years of MCH
practice, and much fingertip expression taught over the years.)
Without my references handy, I can only guess that 1 ounce of pure
colostrum has far more calories than 1 ounce of AIM.
Just my $.02.
Jean
**************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA
***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
