Peg and Marla
I hear you! Some years ago I was booked in advance by a mom who had brain
surgery and wished to maintain a milk supply for her 4 month old. Every
day for several days I went in to the ICU where she was flat on her back,
seemingly unconscious and unresponsive, and showed the nurses how to head
off any possible engorgement. I found that pumps were hopeless for the
reasons you describe. What worked best was hand expression. Actually as
it happened, the mother's milk supply just about shut down immediately
after the surgery. I had expected to see engorgement and there was none,
but I kept showing each shift of nurses how to express for the mom
anyway. As the mom's condition improved and she was moved to the HDU
(still flat on her back) her milk production gradually increased. I have
this vivid memory of shooting a loooong jet of milk up and over the curtain
surrounding mom's bed - mom was by now conscious and we were both impressed.
If I was working with such a mom in such an unfortunate situation I would
think about hand-expressing into a wide bowl. The advantage of this is
that you can point the nipple to direct the jets in a particular general
direction - perhaps slightly sideways. You would need to use a wide bowl,
since the jets will be multiple, and perhaps angled like a radar dish to
catch them, and held/tilted to that the sprays will run down to be caught
in the bottom/other side of the bowl, and emptied into a storage container
from time to time. You'd have to experiment with the angle of dangle, but
this would work a whole lot better than pumping.
When I work with new moms who have to lie flat because an epidural has
leaked, I find that it is difficult to get a spray of milk, so that what
works best is to hand-express and catch the dribble of milk as it runs down
the breast with a small 50 ml medicine cup. I then teach the dad or another
family member how to do it, and try and suggest to the nursing staff that
mom will need help once all the visitors go home, eg at night.
For your mom, I would imagine it would be difficult for her to do this
herself. She might need round-the-clock assistance from nursing staff -
draining the breasts every 3 hours at least. I would think the biggest
problem would be in persuading the staff that this is an important enough
use of their time. However, if they could be persuaded they'd all get
*very* good at hand-expressing!
Best wishes - would love to hear how this turns out.
Pamela Morrison IBCLC, Zimbabwe
[log in to unmask]
At 09:34 PM 03/04/2003 -0500, you wrote:
>We're stumped and hope that someone out there has an answer for us. A mom
>who is nursing a three month old was recently hospitalized for a broken
>back. WE dealt with the medication issues, etc., but now they are saying
>that the break is worse than they thought and that she will have to lie flat
>on her back - possibly for as long as 3 months. Our problem - how to pump
>her breasts while she is flat on her back? It is not possible with the
>brand of pump our hospital uses. Any ideas or suggestions????
>Peg and Marla
>Baltimore, Md.
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