I am finding this discussion interesting!  I strongly believe in empowering 
women
with information to make an informed and supported choice, but just last
week I gave an 18-year-old grav 3, para 1 no choice, but to express for her
34-week premature baby.  I simply assumed that she would want to provide her
milk, with its protective properties for her baby in high care.  Mother
spent more time in the smoker's lounge than with her baby.  Even when
holding her baby she seemed to be focusing on the music in the background.
After 24 hours she decided that she wanted to bottle feed.  I spoke to the
paediatrician and (amazingly) she *insisted* that the mother continue to
express and provide kangaroo care.  Baby is now 8 days old.  Mother has an
excellent milk supply  - with hand expression and, since yesterday, a
bicycle-horn-type breast pump (don't ask!!)  Baby is kangarooing and
breastfeeding during the day and given expressed milk via tube at night when
mother is at home, and best of all, mother and father are in love with their
baby.  I don't expect that baby will be breastfed for long upon discharge,
but at least he has had a good start and had a chance to weave his magic
through skin-to-skin care and breastfeeding.

This is contrary to the way I practice, that I am still trying to figure out 
why I acted this way - I do like the end result though!

 Jean Ridler  RN  RM  IBCLC
South Africa   [log in to unmask]

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