This is exactly what I am talking about. Skin to skin is wonderful, but not always possible. Advocate for the mother and the baby and understand circumstance. There are no studies done on this early prematurity because it is not possible, and often times just moving thsts babies causes desats and the like.

We are not referring to the 32 weeker who can deal with outside complications, we are talkinig about babies that are so premature (and there are a lot of them) that will not be able tophysically handle skin to skin. Pumping is the next best thing for these mothers...and at this point the best thing the mothers can do for their little one.

Julia Augur IBCLC,RLC

Date:    Fri, 2 Jul 2010 08:43:08 -0500
From:    [log in to unmask]
Subject: Re: Skin to Skin is the normal paradigm

I work in a hospital with a level 3+ nursery.  Right now we have several tiny babies born at 22-24 weeks gestation.  These babies have special beds for them, are on ventilators and other life support systems.  They are barely alive.  Please show me the evidence-based information that shows that these babies will survive placed on mom.  And let's be realistic, if indeed it is BETTER for these babes to be on mother (which I think it might be), what mom can sit in a chair 24/7 without a need to pee and eat and sleep?  Plus pump for her baby.  The research done has been on babies 32 weeks and above, I believe.  And these are small studies.  We can't forget that in the "wild" these babies WOULD NOT SURVIVE outside of the womb.  All of our technology is trying to create an environment that is womb-like in it's ability to provide warmth, nourishment and protection in hope of helping a baby survive.  And hospital personnel, including doctors, are not trying to harm the mother-child bond, they are just focused on keeping the baby alive and as healthy as possible with as few sequelae as possible.  We have a heavy emphasis on getting moms pumping, getting the colostrum and milk to the babies ASAP, touching and being with baby as much as possible.  Let's advocate for mom and baby but can we do it in a way that recognizes that most doctors and nurses CHOOSE to do what they are doing and have no ill will towards their clients.  I would challenge anyone who works with breastfeeding moms who have preemies to (if they have opportunity) tour a local NICU and see really tiny babies and hear the miracle stories.  The first lactation course I took as an aspiring consultant was with Marsha Walker and Jeannie Driscoll back in the age of dinosaurs.  It was so eye-opening to move beyond what I was familiar with(normal newborns) into the world of the long-term pumping mom.  This was before kangaroo care was attempted and Susan Luddington's work.  Things have advanced a long way in the years since.

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