The hospital that I work at in  Brisbane,Queensland Australia hasn't done
test weighs in either the NICU/SCN or postnatal wards for over
13years(that's the age of my oldest 3 kids who were all breast fed.).I am
one of those mums who never produce massive of breastmilk and supplied when
needed once I went back to work.
I hand expressed,never could get much with a pump but  went with the
philosphy that as long as I provided something my kids benefited from my
breast milk.

Working in an area where the majority of babies don't go to the breast until
they are many days old.we encourage kangaroo cuddling,having a cuddle(nurse
of baby as we Aussies call it) when possible,doing the babies
cares(change-ups and feeds) when parents come in for visits.

Many of our mums find it hard to supply  their babies with very much breast
milk,our unit supports their efforts by the fact that we have established a
breastfeeding support team with certified LCs and interested co-workers.This
was established after our parents were surveyed and one of their biggest
complaints is confusing/conflicting advise.All staff had to undergo BF
educationg and it is now a yearly competency,appropriate information
packages have been made up for both staff and mothers.

We start our mothers off hand expressing as soon as they feel able
to(depending on their condition after delivery).Pumps are only used once
milk supply is seen to be in.

Generally the mothers are told not to worry about the amount of milk they
obtain at each expression,as long as they keep it going until the bay is
able to lact and suck at the breast.
We all know some mothers could supply the whole nursery and others will
struggle to obtain 10 mls plus each time.
A freezer and fridge to store their milk has been much appreciated byt the
mums as it ensures their baby will get the required breast milk.

When we educate the mums ob how to tell whether their baby is getting enough
at the breast we also talk about the number of wet and dirty nappies within
a 24hr period(approx 8),the baby's latch,if they are sucking properly and if
they are happy and content.Pointing out that some babies like to use the
nipple as a dummy even after they have had enough.Some babies are grazers
and need frequent feeds and others get enough in 5-10 mins(if mum has an
adequate supply).

I suggest that they look at their baby's weekly weight gain,rather then the
second daily weights we do.It gives one a better idea of how well their
doing and as they get older  the time can be spaced out.
Still remembering being told at  a Child Health Clinic visit with my first
child that he should be getting more(he was bottle feeding at this stage as
my milk was viritually non-existence)at least 240mls every four hours
compared to the 120-180mls he took on demand.The child health nurse only saw
that he had put on 30gms that week forgetting that he had put on over 120gms
the week before.I also didn't believe in trying to force this child to take
more then he wanted at a time.Remembering thinking at the time that I was
glad I knoiew something about my child's needs or I would have felt
guilty.Didn't bother taking the next two to Baby clinic,became a nursing
mother's member,attended a lactation course and became more comfortable with
breastfeeding .had them weighed weekly then monthly at the chemist (drug
store) or when they went to the doctors for their immunisation.
I had less problems then my friends who religiously went for their baby
clinic visits.

Sorry this is so long, have just started 2 wks hols and can finally get up
todate with my mail.

Anne Clements RN RM BNS
Brisbane QLD
Australia
Wherre it is sunny(30 degree celisus) and the birds are churping outside,

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html