I would suggest that mothers of hospitalized babies (y) pump for two minutes past the last drops of milk (double, hospital grade, etc.).  I think that this would be in line with Peter Hartmann and also Paula Meier's research for supply and milk fat content.  I think Paula would like to see a "full milk supply" being pumping by one week postpartum as a goal.  A full milk supply would mean 750 ml/day X number of babies.  Now, this is my rendition of what I heard a few years ago. 

I would like to discuss the issue of our being sensitive to the mother in giving pumping advice verses giving the mother the best/ latest information and letting her do "plan B" if she needs to.  Are we assuming that ALL mothers of hospitalized babies (y) are too overwhelmed?  What about the mother of hospitalized babies who can do nothing for her babies but get her supply ready for the big day when a baby can begin milk feedings?  Wouldn't it better for her to pump often and well while she can, while everyone is still in the hospital and then taper off when one or more babies come home or it does get overwhelming? 

Do we do this with our other advice/ instructions?  "Well, I know your nipples are too sore for breastfeeding, Ms. Mom, so  you should put a shield over your nipple until your skin feels okay for nursing."  

I don't know the answer- just asking what you think.

Terriann Shell
Big Lake, AK

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