Karleen said:
<<But Righard's research found that it took an *average* of 50 minutes for
babies to attach??? That's a lot that took more than an hour unless the SD
was very samall (can't find the damn paper in the pile!)
It seems to me that taking the baby away and handing the mum a pump after an
hour is a very bad idea.>>
Wow, what a LOT of misunderstandings!! First of all, it is 55 minutes, + or
- 4 minutes to the first latch according to the research (Righard &
Widstrom). I'm not sure ANYONE suggested taking the baby away and handing the mom a
pump in the first hour. Of COURSE that is a bad idea.
Secondly, I think all of us that are advocating pumping within the first
hour to capture that bolus of colostrum are talking about pumping ONLY when the
baby is UNABLE to breastfeed -- i.e. has been whisked away to the NICU for
whatever reason. We are NOT talking about a normal, healthy infant who is
capable of being put skin to skin and wait it out. We ARE talking about that
baby (like the one I saw two days ago that is in the NICU, and has been in the
NICU for the past 4 days. No one offered this mom a pump until 12 hours
postpartum. Why not? She had a C/Section. She couldn't get to the NICU to
breastfeed immediately. She couldn't do STS -- the baby was in distress. And
when baby could feed, he got formula because there wasn't any expressed
breastmilk available and mom couldn't get to the NICU for every feed yet). C'mon
guys, we need to look at what we are talking about here.
Someone asked about when to start pumping for moms who can't breastfeed --
was there documentation about 6 hours, and I said we should start pumping for
those babies within that first hour after birth to capture that bolus of
colostrum (and gave an example), and the posts from there went zonky! Everyone
that thinks we are talking about normal healthy newborns who can stay with
their mothers completely MISSED THE POINT!!!
The assumption is that an intervention will be needed because mom and baby
are separated. The POINT IS: PUMP within that first hour. Or hand express.
But GET THAT BOLUS OF COLOSTRUM so you have something to feed the baby as
soon as the baby can be feed instead of waiting, having the bolus shunted back
up the ductile tree, and being unable to get anything at 6, 8, 10, 12 hours.
I have another mom that had a C/Section. Baby is 38 weeks. Weighs 4-12
(hmmmmm). Went immediately to the NICU. When I came in to see mom at about 10
hours pp, there was no pump in evidence. The NICU staff has already told mom
that she can pump and will be feeding the breastmilk with fortifier in a
bottle because "breastmilk only has 20 calories/ounce" and the baby needs much
more than that to grow.
Sigh.
One more example -- another person who lurks on Lactnet shared w/ me, and
told me to share w/ y'all that a mom whose baby went to the NICU immediately
after birth asked to pump at 1 - 1 1/2 hours after birth because she was
feeling uncomfortable. She got 10 (that's TEN) ounces! Now -- unusual? Of
course. But the point is, why are we waiting when we KNOW the mom is going to have
to pump -- and why are all these babies getting formula instead colostrum???
Although I resonate with Rachel's post, I too think it was taken a bit out
of context.... what's happening in many facilities though is that if the baby
doesn't latch on within that first hour, they are shipped out of L&D and to
the PP unit, and often the baby is taken to observation nursery. So it is
happening, Rachel -- though not quite yet exactly as you described.
Sorry for the yelling (yes I am), but I do think we need to READ the posts
-- go back to the first one and see what the thread is -- before making
assumptions that aren't there. Or ask for clarification.
Jan Barger, RN, MA, IBCLC -- whose daughter was pointed out at church today
as being the only Bears' fan there. (They live in Indianapolis, in what they
are terming, "a house divided"). We, of course, are in comfortable Bears
country....
Wheaton IL (3 1/2 hours until kickoff).
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