Hi All - Gonneke wrote:

 

    That said. I return to the question that raised (in my mind) in the
begining of this discussion: why in the first place are women advised to
pump to increase their milk supply? Is it not so that a baby at breast is a
far more effective means of increasing a good enough milk supply? I
professionally as well as personally think that asking a mother to feed at
breast *and* pump *and* supplement her baby is way to much. Why not have mom
feed baby more often instead of all extra pumping sessions? Why not advise
mom to keep baby close to raise prolactin levels and be aware of any signal
baby gives that shows readiness to nurse?

 

 

Jaye again - Gonneke - thanks for the question.  Here is my answer with
explanations.

 

Why are women advised to pump to increase their milk supply rather than
nurse the baby more often?  There can be many reasons for this - the baby
may not be able to nurse as well as s/he needs to get enough milk -
therefore the supply would drop and the baby would suffer by losing weight.
Then you really have a problem.  Also, if baby must nurse 20 times a day in
order to get plenty of milk - my question would be - when does mom sleep?
When does mom pee?  When does mom shower or eat?  When does mom have a life?
We need to make things doable for her in any way possible.  My clients have
a routine that they follow to not only give baby time at breast, but be able
to pump, supplement as needed AND shower, eat, pee and sleep!  It isn't
always easy - but it works.  I also give them other options within this
routine that make it doable for them while working steadily towards baby
being on breast ONLY.  BTW - (depending on the baby's abilities) I also
sometimes have moms in this situation doing pre-post weighs to ensure that
baby is getting enough milk in a 24 hr time period.  Now that is a lot of
work!  But they do it.willingly.with informed consent.knowing why they are
doing this and exactly how it will help them in the long run.  They can
choose to do that or not - and if they choose not they know what they need
to watch for to make sure baby is getting enough.  Most choose to use the
scale preferring to know for sure that all is going well.  It is a luxury we
have here in my area to be sure.it makes a difficult situation easier in
many ways.more complicated in others.  :-)

 

So is it a lot?  Sure.  Is it way too much to have them do?  Maybe for some
so we work around it. But for the vast majority of moms I work with, they
are willing and able to do what needs to be done to protect baby and milk
supply.  I think by assuming it is way too much for all moms to do we
underestimate their ability.  Moms have surprised me many times with what
they are able to and willing to do to get to full BF - what they are willing
and able to do to feed their babies.  I have worked with MANY moms whose
babies were NOT capable of sustaining mom's milk supply for a variety of
reasons.  Having been a mom who pumped, and bottle fed and breastfed at the
same time - I FULLY understand the nature of what I ask some of my clients
to do - I tell them my history so they KNOW I understand.  They also know
that it is temporary.  And I praise the hell out of them for the work they
are doing. 

 

Oftentimes, knowing that she can sustain the milk supply while working with
the baby on the breast, and knowing it is a temporary situation gives mom
just exactly what she needs to get through.  Knowing that she is working
hard right now but it will not last forever is also helpful.  Knowing she
can call me 7 days a week and we can rework her routine if needed is a
support system she needs and also helps.  Knowing she has OPTIONS is vital.
And what is really cool is when they get past the issues and are at that
full-on breastfeeding at breast only stage - wow are they proud of
themselves and the work they did!  

 

Just my thoughts.

 

 

Jaye Simpson, IBCLC, CIIM

Breastfeeding Network

Sacramento, CA

www.breastfeedingnetwork.net

 


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