Gee Judy, this little one does sound to have quite a severe case.  Knowing
next to nothing about the condition though I will just read and learn.  My
elderly mother developed a similar condition in her later years and her
drinks also had to be thickened with a thickening agent similar to what
Chris describes.  I too would feel that this would be much better for this
little one than introducing cereal at such a young age, and as Chris noted,
the breastmilk very quickly breaks it down to be quite runny again anyway.
Re pumping... applying the research of Peter Hartmann ... the frequency
this mothers needs to pump (noting that baby isn't going to breast),
depends on her breast capacity - particularly several months down the track
now as this mother is.  If she is able to get as much milk as her baby
needs (plus maybe a little bit for a rainy day) during her usual waking
times, then I wouldn't suggest that she wake at night to feed.  However, if
she has a smallish breast capacity she may have to express during the
night.  This is an entirely individualised thing and we needn't set rules.
My first ah-ha moment with this concept was when a midwife colleague told
me that, for whatever reason, she always expressed and bottle fed her
babies.  And she only expressed twice a day!!  and met all of her babies
needs until they were well into the second half of the first
year.  Regarding the pump - it's what works!  This particular woman used a
Kaneson - for the 'younger' LCs amongst us, that's a barrel-like hand pump
- looks like a big syringe and is positively ghastly IMO, but it worked a
treat for her for over a year.  In Australia we have NEVER had "hospital
grade" pumps like the Classic and yet our NICU mothers managed to produce
wonderful milk supplies equally as good as in those places that do have
them.  We have only just got the Symphony recently and not that many places
have it.  And in most places of the world, the only pump they have is their
hands.  As I said, it's what works and I don't think we should be
prescriptive about what they must or must not use... particularly where a
lot of cost is involved.  We know that so much of breastfeeding is
self-confidence, and I feel that being told that you can't maintain a milk
supply for months only using a [insert anything less than hospital grade
pump] just becomes a self-fulfilling prophecy.
This is a bit like our discussions of latching isn't it - there is no "one"
answer.
Next thing I would like to know is what evidence-based research does HMBANA
use that proves that thawed breastmilk must be used within 4 hours?  Is
this after it's been heated or used in a bottle or something?


Denise Fisher MMP, BN, IBCLC
Director, Health e-Learning
http://www.health-e-learning.com

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