Rachelle writes -

>
> You asked if it is common practice in the U.S.  to use an electric pump
> from birth.  Do you mean if the baby is not nursing?  If the policy in
> Australia is to not use an electric pump until the milk comes in, how
does
> the milk come in when the baby is not nursing?
>
We promote hand expression as superior to electric pumping, especially
prior to milk coming in. Even following milk coming in, the extra
stimulation of compression of the milk sinuses promotes more thorough
emptying of breasts. Particularly useful for mothers attempting to increase
their supply - post feeding. There are also studies that show mothers
expressing for prem babies achieve a higher volume if hand expressing is
combined with electric expression.

 If a baby is unable to latch at breast, the practice where I work is to
hand express milk into a teaspoon and give it directly to the baby in
mother's arms (the midwife would do the expressing in this instance). Many
times after a few teaspoons have been given to this sleepy baby, he/she
starts to mouth around and can then be latched on the breast.

We generally do not use an electric pump until there is a reasonable volume
of milk to make it worthwhile. Very demoralising for the mother when only a
few drops line the pump. At the hospital where I work we did not have
electric pumps until 5 years ago.We managed with hand expressing or hand
pumps.

We have a very good video we show the mums - "Hand Expressing and Cup
Feeding" made in Melbourne Australia - featuring Wendy Nicholson (IBCLC).
You can purchase it from NMAA (Nursing Mothers Association Australia).

Regards,  Roslyn Draper, RM IBCLC Melbourne, Australia [log in to unmask]