I am currentlly working with a mom who might have benefitted from earlier pumping, but one never knows
.  When I was working in the hospital I got frustrated with the approach that baby could come out of special care at any time (not premies or really sick babies, but the ones with what were likely transient "problems"), so why pump until we know for sure.  If baby didn't come out, by the time pumping did get started, the early window was gone.  I find that moms who pump within the first hour after delivery get more than those who wait.  That goes right along with the rationale for helping baby nurse in that first hour (or not interfering with baby doing it him/herself).
 
The mom I have been working with was thought to have been a likely gestational diabetic.  She was noticing drops of liquid in her bra the last couple weeks.  Glucose testing was normal, so no gest diab.  We had discussed pumping in advance to have some colostrum available if baby had low dexis.  Mom planned to have immediate StS and "breast crawl".  Unfortunately, baby had some distress in late labor and needed some extra attention right after birth (first Apgar was 5-second was 9)
.  By the time baby was OK to go to mom, that initial "window of opportunity had passed and baby was not interested.  It didn't help that baby had been inutbated for a few minutes.  Then hospital procedure required that baby go to the nursery for its admission assessment.  Mom and grandma tried to get them to do it in mom's room, but to no avail so grandma went with baby while mom was transferred to postpartum.  Once the admission was done baby was rooting, but the ped was making rounds so of course, baby had to wait.  Heaven forbid that the ped might have to wait or even worse, do her exam in mom's room.  Ped was very meticulous, so it was another half hour and baby went to sleep.  By the time she got to mom, it was "no sale".  Mom did cuddle skin-to-skin.  Then, as a result of the stress baby had been under, her temp wlouldn't stay up, her blood sugar was down and she was jittery.  The nurse was very apologetic that baby would have to have
 formula.  Mom asked if she could pump colostrum.  She got a couple ccs and nurse was very helpful to use a few drops of water to be sure all the colostrum was collected and given to baby.  Baby was then given a scant half ounce of formula using paced feeding technique.  No surprise, still no interest in nursing.  
This is getting long, so will send and then cointinue with part 2

 

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