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SUBSCRIBE LACTNET Jacalyn <[log in to unmask]>
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Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 5 Jan 2017 10:38:06 -0500
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Tricia
This is a great post!!  I get a little frustrated when I am at a conference or reading references that mom's should be expressing large amounts of colostrum.   I often sit and think, are they on a mother/baby unit?  This is not typical.  I usually tell Moms and newer nurse, expect about 2mls, sometimes drops and then pleasantly surprised when you get more than 5ml on day one.   Sure there are some moms, multips, or those that have been leaking that can express 5-10ml, but rare.    I agree with the decrease in colostrum day 2 (and it's only my personal evidence based practice)  I tell moms the first few expressions they may see a substantial amount (2-3ml average) and then less, maybe only drops.  

 I agree about pumping vs hand expression.  A majority of moms do not like HE and admittedly, I'm not the best at it.  Certainly, if a mom has been leaking, or I am assisting with latching and colostrum there, I have better success.
I do teach hand expression to all moms, but they want to pump.  So many moms ask day 1 if they could start pumping b/c they want to see how much the baby gets.  Of course we discuss the baby nursing, is better etc.       I also explain (and show what 2ml looks like) that most of that small amount is in the pump, on the flange etc. Whereas, hand expression we have every drop.    If a mom has to pump during the hospital stay for supplementing, pre-term, etc. I do teach hand expression & pumping together.  
Just my opinion, but with more accessibility to pumps and insurance coverage more and more moms just want to pump, not even breastfeed.   

For supplementing, we follow ABM protocol  usually begin with 10ml on day 1.   However, with the Pediatrician coverage varying and in transition here, we have a variety of opinions on this.  

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