<Ann wrote: I would like to see research on use of hand expression in
the first 6-24  
hours pp with mothers whose babies are unable to feed.  Then to  compare
them to 
the mothers who have been given a pump to bring in  their milk supply.
Ann Perry, RN IBCLC Boston, MA  >
 
I would be happy to participate in such a study.  
 
I think I have more moms hand expressing and feeding the colostrums by
spoon,  than breastfeeding on some days, in my hospital.   I suggest
about 3-5 spoons every 2 hours during the day.  I use tiny plastic
spoons.  This method helps in many ways: 
1. it helps moms get an idea of breast function and anatomy, i.e. the
milk is not in the nipple, it is in the breast!!
2. when they see the colostrum, they realize that they actually do have
milk ( very high doubt factor here).  This works well with use of the
belly balls to see just how little the baby actually needs. Pumping in
those first few days only increases lack of confidence as those golden
liquid drops get lost in the process and rarely get to the baby.
3. maintains milk supply.
4. helps soften edematous breasts
5. prevents too much weight loss in the baby
 
Most babies will go on to latch when they are ready, and until they do,
they are getting mom's milk in a way that does not interfere with
sucking.  This also really helps with babies who were suctioned due to
meconium stained amniotic fluid, or just are not ready to feed yet.  It
helps those babies who are keeping their tongues in defense mode.  They
start sticking out their tongues to get the colostrum.  
 
Esther Grunis, IBCLC
Lis Maternity Hospital
Tel Aviv, Israel
 

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