In a message dated 2/16/2004 10:25:59 AM Eastern Standard Time, [log in to unmask] writes:

> <<I'm still trying to figure out why one poster noted that so many
> mothers find pumping hard.>>
>
> Are you serious?
>
> Many moms find just caring for a newborn  challenging, add pumping 8x
> per day and it's enough to push most of them over the edge.


I am very sincerely serious. (And tried to respond twice earlier and somehow managed to "lose" the post.) And most of the mothers I'm working with have 2 or 3 newborns, so can't think of even one I could say had a "breeze" situation.

I am not referring to situations re: delays in which baby/babies demonstrate behaviors consistent with effective suckling. Then I can understand how the SNS can be the better option. (I find many MOT/MOM who find dealing with SNS or Lact-Aid as an overwhelming thought. I gently push or back off based on more data from them.)

I'm referring to most delays I see, which more often than not related to baby/babies that are not yet effective and/or maternal issues that delayed BF initiation and frequent BF, e.g. surgical deliver, PIH and 24-hour postpartum MgSO4, etc. In these situations, improving milk removal is crucial yet baby/babies cannot yet do it. So if they can't, something has to. I find most will hang in better with a breast pump than with hand expression.

I totally agree there is a learning curve, but maybe part of the issue is the pumping routine that "fits" the situation and tapping in to support in the form of physical household helpers. Those things can be key to "doable" or not. I'm amazed at the number of mothers who say they BF an ineffectively suckling newborn for up to an hour or more at a pop. What's the point of keeping these babies at breast so long vs. limiting and removing milk a (currently) more effective way?

So-called "practice/practise" BF are often more useful with ineffective feeders and then mom still has time to pump/remove milk to establish and maintain production. Physical helpers can be useful to help with a toddler, be extra arms, give an alternative feed (with proper technique instruction) -- that then is more likely to be EBM, etc. When baby/babies clearly are not effective at breast and something more has to give, I've even been so bold as to suggest a BF "time out" for a couple of days so mom can focus on removing milk.

> But if the
> baby is nursing well, I can't find a reason why pumping should be part
> of the recommendation to a mom if an SNS and domperidone
> (or other
> MM/MMP) is a good solution for her.


In many such situation, I'd agree, but I simply don't see this very often compared to situations in which baby is contributing via less than effective suckling.

Karen

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