Jane,

Have you read the full-page letter to the editor in the newest JHL which
gives a clinical practice hint that addresses this very issue? It is a
suggestion on how to manage early pumping while the mom is lying down,
without losing a drop.

I also love Diane Wiessinger's handout "How We Make MIlk", at least for your
administrators.

Perhaps you can have the best of both worlds by teaching the moms (RPS if
necessary) then fingertip expression in the first few days to get some milk
removal started, and collect what you can, since for many moms, IME pumps do
not usually remove milk as efficiently, or at all during this early period.
Any milk removed by hand would certainly encourage the mom herself to ask to
pump when it begins to increase.

You might point out that physiologically, milk removal would theoretically
stimulate oxytocin, and therefore reduce risk of hemorrhage at least;-)

Jean

K.Jean Cotterman RNC-E, IBCLC
WIC Volunteer LC
Dayton OH USA

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