Dear all:


First, please note that my email address has changed from:  [log in to unmask]
to  [log in to unmask]

Second, since our practice unfortunately deals with a lot of iatrogenically induced
low supply, some physiologic low supply, a fair proportion of premie twins, and
moms that wouldn't breastfeed at all if they didn't have the baby nurse take over
during the night,  we have to deal with the realities of pump use and the trauma that
can sometimes induce.  I'm thinking of doing a blindFOLDED study on breast shields
for pumping.

Pick a group of women who are currently using pumps.  No exclusive breastfeeders
whose babies have never received bottles since I think the disruption would be
unethical.

Have one interviewer interview them about their reasons for pumping and any
difficulties they may have encountered.  Particularly looking at women who do not
release well to the pump, women who have experienced numerous bouts of
plugged ducts, blebs or mastitis, and women who have low supply whether
iatrogenic (probably the most prevalent) or due to insufficient glandular tissue.

Have another person work set them up with the pump in our support group room for
the following:
a) blindfold them
b) measure nipple size with one of those devices with holes that tells you the
diameter
c) have random assigment of their breasts to their regular breast shield versus
another shield type &/or  administration of olive oil by picking an envelop with
"treatments (shield type/olive oil) for each breast"
d) set them up with the pump shields using a hands free device
e) turn on some soothing music
f) digitally photograph each breast at the entry point to the shield at 5 min. into the
pumping.

After pumping, another interviewer who was not in the room during pumping will ask
various questions about pumping comfort.

They would then be given a lunch break.

After a 3-hour break they would then be blindfolded again and the treatments would
be switched.

Soooooo,   an ethics question for all of you.  If two different companies donated the
shields for testing under those circumstances ----- would you find ethical problems
with this?  What other sources of $$$ could be used for purchasing the necessary
equipment and possible incentives for women volunteering for the study that might
take away any perceived cooptation from the companies that make the breast
shields?

I was thinking of providing a nice catered lunch - and free attendance for several
sessions at the breastfeeding support group.

Any comments on this rudimentary study design are most welcome.  So far, its the
simplest, quickest study I have imagined doing.  The first that I have actually thought
I would have the wherewithall to actually implement given my lack of free time.

Best regards,

Susan E. Burger, MHS, PhD, IBCLC

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