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In a message dated 6/18/2005 11:08:29 AM Eastern Standard Time,
[log in to unmask] writes:
How many lactnetters feel comfortable getting mom's permission and using
hands-on to teach mothers to express? I'd like to hear if anyone shares
my impressions (or not). When staff or mom don't feel comfortable with
early feeding effectiveness, and/or the pediatrician feels the need to
verify visual amounts before discharging the baby, I think that teaching
the mom this skill would be a better, much less expensive and more
reassuring compromise than jumping to a pump first off or keeping the mom
an extra day.
Jean, every mother I visit in the hospital or an outpatient visit, I have
them start with hand expressing. The reason I start this way is to show the
mothers that they do have milk and to teach them at the same time how this is
done.
I do not do the expressing but show mothers where to place their thumb and
fingers and if they don't understand my instructions I mimic on their arm and
will place my fingers over theirs sometime. I do not like to do the
expressing myself for 2 reasons; one I may apply too much pressure, and two I want
the mother to feel the empowerment of her accomplishing this task herself.
Every mother gets some colostrum. The mom with edema is definitely more
challenging but I still can get them to see some wetness. The more the mother
does this the easier it gets for her.
When it comes to amounts a mother gets from the first day postpartum to the
next, my challenge is to the medical model who is assuming that 1-4 ounces is
a normal intake because that is what bottles have and anyone can force these
amounts down poor babies gullets.
Showing the pediatrician how much a mother can produce I think would be
counter productive in general. If that was where your question was going.
Ann Perry, RN IBCLC
Boston, MA
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