On Fri, 23 Feb 2001 10:41:51 -0500 "Diane Wiessinger" <[log in to unmask]>
writes:
> >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.
>
> Do you mean 1/2 ounce per side or 1 ounce per side? If you mean the
> latter,
> you're saying a baby can get a 2 oz feed early on. I'm inclined to
> agree
> with you, with very little early-feed experience. I've always
> suspected
> that the low, low intakes we tout as normal are mostly poor
> positioning and
> limited time. I wonder what happens in other mammals...
>
> Diane
Well! Thank heavens you answered! (No one else took the bait!) After I
pushed the send button, and then read that everyone else was quoting the
17 or so cc. size stomach etc, I thought "Well, maybe I was too generous
in my estimation! Surely someone will flame me!" Nada. Zilch replies.
Actually, I was thinking of the many times I have gotten 5-10 drops
easily on prenatal breast assessment while showing the mother. And that
was only in ONE fingertip placement location! True, you have to know just
where to compress, and use the inward pressure before and during
compression.
But it's easily learned with practice, and it doesn't have to be painful.
If it is, that means the sinuses are very full, and a minute of RPS
before the first few times will fix it!
I was thinking of a pattern sort of like the !Kung nursing pattern in
that 1 minute of expression in 2 opposing quadrants on each breast about
every 15-20 minutes or so, with a minute of massage on each breast would
add up to 3+ times per hour, and that by 4 hours, the little medicine cup
staying right at mother's bedside would surely have 450 drops (each cc.
of water has about 15 drops if I remember correctly, so 15 x 30 cc. = 450
drops, and who knows, thick colostrum might make larger drops!)
Maybe my math is way off, and I admit there are some few mothers with
very deep placement of the sinuses in whom I was never able to palpate
the sinuses prenatally, or even postnatally till they were actually
leaking.
But I sure do wish some knowledgeable mothers could be persuaded to try
it, just to prove me wrong! Of course, I mean someone whose baby is
necessarily separated from her anyway, and she could be reassuring
herself by collecting calories to deal with any incipient hypoglycemia
the nursery might "threaten formula" to deal with!
I often noticed in the "olden days" in the hospital probably on days 2-3
and beyond, that babies who had been nursing mainly in the same position
would have softened up the area in line with their nose and chin, whereas
the areas corresponding to the corners of their mouths would be both
edematous in the tissue and full in the sinuses beneath the edema.
That's when I began recommending to moms to use various positions
throughout the feeding or at least throughout the day, as by testing with
fingertip expression, I noted I could get a lot more using two opposite
quadrants after the first position I expressed slowed down.
I don't know if you sent this to LN, but I think I will just to see if I
can interest someone in refuting it by trial. I really don't see mothers
that early any more.
Jean
***************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA (Just back from 2 weeks in Phoenix where the weather was
a teeny bit better than Ohio while I was gone, but not as much as in
other years.)
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