Linda, I think each preterm situation is different.  However, many
breastfeeding preterm infants may not be able to adequately "drive" the milk
supply.  It is important for the mother to initiate a good supply that the
baby can grow into.  Does this always necessitate an electric breast pump?
I my experience - no.  (I have seen a teenage mother produce a plentiful
supply with - shudder - a "bicycle-horn pump"!  I have also seen hand
-expression work.)  An efficient electric pump is, however, convenient.
Whatever the mother uses, *frequent* removal of milk is important, starting
as soon as possible after birth.  There is research - but I am not in my
office right now to check.

Jean Ridler  RN  RM  IBCLC
Cape Town, South Africa

> 
> I am looking for opinions as I update policies and protocols at my new
job.
> If there is research to back this up, I am not finding it.  One protocol
is
> for all mothers of preterm infants to pump for two minutes to "bring the
> milk down", then breastfeed, then double pump for 15 minutes.  Another is
> for all mothers who have had a postpartum hemorrhage or who were on
> magnesium sulfate to initiate pumping every 3 hours.  I am finding all the
> pump promotion, marketing, sales, and rentals makes breastfeeding seem
> difficult at best, that every mother needs an electric pump because the
baby
> is unable to adequately do the job.  I also feel this dependence on
pumping
> is unethical because the hospital and the pump vendor are profiting.  Do
you
> see any basis for these recommendations?  Am I missing something?
> 
> Linda Anderegg, BSN, RNC, IBCLC, RLC in Chicago
> 
> 
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