In a message dated 2/5/2004 4:46:50 PM Eastern Standard Time, [log in to unmask] writes:

> PRO-LC, my local affiliate, had an eye-opening presentation in November 2003
> by Diane Spatz, PhD, RNC, who shared the results of her (as-yet-unpublished)
> study, Strategies to Improve Breastfeeding Outcomes in Low Birth Weight
> (LBW) Infants with Short Hospital Length of Stay (LOS).


Do you know when the data's to be published and where? Did she provide info re: her study and control groups, e.g. maternal demographics, LBWs include term infants that were SGA, range re: length of gestation at birth, etc.? Thanks.


>
> Her surprising finding: it takes *6 to 8 weeks* for baby to nurse
> effectively enough that all caloric needs are met at breast!  Until then,
> Mom needs to be doing extensive pumping to protect her supply, and needs to
> be monitoring her baby's improving transfer capabilities with pre- and
> post-feed weighs on an accurate scale.
>

I'm not surprised by her findings. I work with a lot of mothers of twins/multiples (MOT/MOM) and, more often than not, they find themselves in this position but with two and occasionally three babies. Based on their situation, to full BF tends to concur with her findings. And the MOT/MOM I talk to definitely are more likely to continue if production is protected from the get-go via pumping.


> So what did they get that the control group did not?
>
> 1.  Early breast stimulation.  The study group moms *went home* with a
> hospital-grade pump, and were instructed to use it 6 times/day, in addition
> to whatever nursing was occurring.  (The control group moms also got a pump
> and instructions – but not the intensive follow-up support.)
>


I hope if not much BF was yet occurring, they were instructed to remove milk more often...


> 2.  Accurate baby scale.  This helped the study group moms accurately assess
> baby’s improving transfer rates ... and to reduce their pumping accordingly.
>  The moms liked the no-doubt-about-it information the scale could provide.
>

I've never found mothers in this kind of situation are bothered by such things pre-/post-feeding weighing when feeding appears to have progressed to some sustained nutritive suckling -- doesn't discourage and tends to encourage.


> 3.  Nipple shields.  Many in the study group used a nipple shield after milk
> had come in ... and for the babies who needed them, it often took until 42
> weeks gestational age until it could be eliminated.


Sounds as if there was some careful assessment re: need to use? And the 42 weeks gestational age til elim fits with the data shared earlier re: time from birth to effective BF.


> 4.  Intensive follow-up care.

Wow! Did she say if all f/u home visits third party reimbursable? If not, was there a special grant for the research or how covered? This is the piece that is so needed. How was pump provision covered? Did she say or include in syllabus?


> Skin-to-skin was part of the protocol.
>

Yea -- one of the best transitional devices and free!


>> In Dr. Spatz's study, 14% of the study group stopped BF at less than 30 days
> ... and none of these moms stated BF-related reasons.


As per Winnie, I couldn't figure out what non-BF-related reasons could be...


> The study group that
> continued to BF went on to do so for a median of 145 days.

Sure beats no BF, but still less than 5 months. Did she have any idea why so many stopped by then?

Thanks so much for sharing this info. I look forward to the published report!

Karen G

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