In einer eMail vom 27-5-04 1:18:28 West-Europa (zomertijd) schreibt
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> I'd like to take this discussion one step further......what are typical
> indications for pump usage in the first couple of weeks? Are there LCs out
> there
> that recommend pumping for every overly full mother, if so why? I,
> personally,
> am concerned about the stimulation effects of pumping on the already ramped
> up,
> overproducer. Any thoughts?
>


Typical reasons why *I* recommend pumping is for pre- or dysmature infants
that can not drink themselves or where mom is not able to see baby often enough
to feed at breast or where hospital rules beyond my influence "forbid" mom to
feed at breast for all or several feeds. (Yes, I do educate these moms in
strategies to get around these rigide routines, but in the mean time ...). And
starting a couple of weeks before mom has to get back to work.
Typical reasons why moms want to pump is becasuse they think pumping is part
of normal course of breastfeeding, because they think it is a good idea to
have milk for anyone who wants to bottlefeed their child and moms who are
convinced that it takes 10 weeks to built a reasonable supply of freezermilk.
In cases of oversupply I do not recommend comfort pumping. In severe cases
where block feeding alone does not get the prodcution down I advise on a case to
case base to  pump both breasts as empty as possible in order to get a fresh
start for blockfeeding. This is done once a day at most, but getting it spaced
more as quickly as possible. My rationale behind this is that comfort pumping
is bringing the message that every feeding must be bigger in volume, so more
and more milk is made. Pumping very occasionallya "full serving" indicates
only one extra feed. I know it sounds to be in contradiction with Hartman's
findings and it may sound counterintuitive, but practice shows it works.

Warmly greeting,

Gonneke van Veldhuizen, IBCLC, LLLL
Germany - The Netherlands

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