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Date: | Wed, 7 Dec 2005 13:07:07 -0500 |
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Jean and Others: OK, I will attempt to tell it like it is re: lactiferous
sinuses and hand expression from the viewpoint of someone who has been
there and done that. When a mom is hand expressing milk, even the small
amounts of colostrum in the early days, there is a certain spongy "feel" to
the areolar/nipple complex. Mom has to position her hand with all four
fingers below the breast with thumb above just at or just beyond the
areolar margin. I believe that the instinctive "push-back" into the chest
that moms seem to just know to do is what helps her seat her fingers just
behind the lactiferous sinuses (sorry, Peter Hartmann, but I know there is
something there) and this is what causes her milk to squirt as she
compresses her areola/nipple between her thumb and fingers. When she lets
go of her nipple with her fingers and moves back to reposition, the
nipple/areola "refill" causing a spongy feel to the areola and nipple.
This "emptying/refilling" occurs quite rapidly and is how an experienced
hand-expresser can fill a bottle in just a matter of minutes.
When I teach hand expression to a mom who is in full lactation, I will
place my fingers over hers while she expresses so that she can see the
pressure/rhythm she needs to attain. When I take my fingers away, she
continues, happily squirting milk into a cup. I have never not been able
to hand express a lactating mother. It's all in the hand position and
rhythm.
I hope this makes sense, as it's hard to put the feeling into words.
Pam Hirsch, RN,BSN,IBCLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL USA
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