Thank you for your testimonial and your vote of confidence Esther.

Just one thing I would like to see changed in your practice as you
described it:

<Short strokes at first, then
longer ones.  It is quite painful, but you feel results immediately.>

This technique need not be, in fact, ought not be painful. It just takes
a little more time when you gauge the speed of what you are doing by the
mother's body language.

If it is done gently, and slowly, it may take longer, but I would not
want to cause bruising, painful memories or other types of trauma.

I can't help but think that it has to be less traumatic to the subareolar
tissues than the vigorous use of a breast pump when the breast is
beginning to swell or already swollen. (This includes hospital grade
breast pumps.)

Trouble is, with short maternity stays, much of the aftermath of
"superengorgement" partially due to IV's., etc., happens shortly after
the mom gets home.

But with so many inferior grade pumps readily available in the nearest
drugstore, too many moms report very painful pumping experiences in
trying to deal with this problem.

The technique can be taught on the phone, but I find it's more effective
in person. In fact, I suspect that teaching it in the hospital before too
much swelling has set in might actually head off worse swelling by
facilitating good latching early on.

I doubt that I can take either of your suggestions, but I surely do want
to make it better known so others can try it and see what they think.

I know this isn't "real research" other than having read a lot of
background literature, but sometimes, we have to crawl before we can
walk!

I don't think slapping a pump on every other mom is exactly
research-based either. A lot of folks seem to be "pump-happy", but I
don't think it's always as innoccuous as many HCP's seem to think.

Sometimes I wish I could say to them "Folks, we're not dealing with a
straw immersed in liquid, or a syringe and needle directly in contact
with a liquid here. Think about it. Suction doesn't pull on milk. It
pulls on flesh!"

I suppose "hands-on" and "hands-off" issues may play a part in that, but
we won't go there now.

Jean
*****************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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