Thanks Jan for your response re: the bolus, etc. I agree that this would
make a great study! I would especially be interested in the bolus related
to different "types" of birth experiences, especially the repeat or
scheduled cesarean births. I have talked to NICU mothers who pump and they
tell me how they got a bolus with the first pumping session and now have
been getting only drops--- so I then go into my speech about labor and
oxytocin and the bolus and I'm interrupted by her telling me that she had a
scheduled cesarean without labor! This has happened too many times to
count, so it has kind of thrown my idea that the oxytocin of labor helps
"bring down" the bolus. I still talk about it and believe it, but if I ever
get myself together to do my Master's degree, this would be a ready-made
topic for a thesis or study. I probably should be doing my own search for
research that's out there about this.
Someone wrote me privately that she also was seeing the boluses from delayed
first pumping times and was interested in this topic, also.
Melinda Lueck, RN, BSN, IBCLC, LCCE
Perrysburg, OH
<<Melinda writes:
<<I am so interested in this. Jan, do you know where I can find the Geddes
study? I continue to find that a high percentage of mothers can obtain
this bolus even if they cannot pump until after the first hour. A mom
recently was too ill to pump until right about 24 hours after birth, and
she still was able to obtain almost an ounce of bolus. We very rarely are
able to get our NICU moms pumping in that first hour, but I've gotten very
used to walking in a room and having a mom exclaim that she got "a lot"
with the first pumping (which could be anywhere from 3-6 hours or longer
after
birth)
but now is only getting drops. so she gets lots of reassurance and teaching
of hand expression and "hands-on" pumping!>>
<<I'll have to see if I can lay hands on the study. With my organizational
skills (not) it may be awhile. Meanwhile, I'm totally fascinated by the
fact that your moms get so much 3 to 6 hours later (or a goodly percentage
do). And Nikki, do you know when they did the first pump vs hand
expression in the Oyama study you cited? That would be interesting too.
<<I think the whole thing would make a marvelous study, and don't know why
someone hasn't done it. I haven't actually worked in the hospital since
2010, and at that point, was only a "visiting" LC for a group of
pediatricians, so didn't have the opportunity. But I have it all laid out
in my head if someone is interested.
<<Things to look at:
1. Type of birth (induced, stimulated, repeat C/S, in labor on own
culminating in C/Section, normal spontaneous vaginal delivery -- do they
have those any more?)
2. A group of women doing only hand expression starting at 1 hour
3. A group of women doing only pumping starting at 1 hour
4. A group of women doing only HE starting at 6 hours
5. A group of women doing only pumping starting at 6 hours.
<<Is anyone else seeing the large boluses that mothers are getting later on
down the road as Melinda is? I never did -- but as a "visitor" I didn't see
everyone. Nor did I keep track of those I did at the time in term of how
much they pumped/expressed.
<<In the Parker article the moms that pumped at 1 hour got an average of
4.19 ml (not my 10-20, but these were moms of VLBW babies, and I have no
idea about their births). Moms that pumped at 6 hours got an average of
0.1 ml.
And that is where I know they would have gotten more had they done hand
expression at 6 hours. I don't think anyone has looked at pumping within
the first hour on a big scale and looked at any of the parameters.
Jan Barger, RN, MA, IBCLC, FILCA
Lactation Education Consultants
Wheaton IL
***********************************************
Archives: http://community.lsoft.com/archives/LACTNET.html
***********************************************
Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome
|
