I am a lactnet “lurker” and IBCLC working at a hospital postpartum unit.  I
decided to venture out of “lurkdom” to ask your opinions about a situation
that came up recently.

In the case of a mother who desires to breastfeed but has given birth to a
baby with a poor prognosis, how soon, if at all, do you recommend that she
begin expressing breastmilk for her baby?  I checked the archives and was
able to find recommendations for a baby that has died, but what about a baby
who does not have a lethal defect or illness, but is not doing very well?

Recently there was a mother facing this situation on our unit.  The nurse
caring for her confronted me and told me that it was cruel to bring in a
pump and teach her how to express milk because it would give her false hope
and intensify her grief if her baby dies.  Are any of you aware of any
research out there to support this viewpoint?  Does expressing breastmilk
for a baby really make it more painful if the baby dies?

My opinion is that the mother should be given the option to express her milk
for her baby, and that her choice should be respected either way.  I
personally have not been in the situation of potentially having a baby die,
but I wonder if avoiding the topic of pumping will really protect her from
painful feelings and false hope.  I think it would be an extremely painful
situation no matter what happens.

So what do you say?  Am I totally off my rocker? Are you aware of any
research in this area? Do you think it is better for her to wait a day
before pumping just to see how her baby is doing before deciding whether to
start expressing milk?

Thanks,
Christy Van Orman, RN, IBCLC
Salt Lake City, Utah


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