Julie-Ann, I wonder if it would help to make an analogy to other skills, like learning to place an IV?  No one expects that every nurse will "get it right" the first time.  They first learn the basics of the technique, then they learn how to apply that knowledge.  With repeated practice they learn just how to feel for the vein, how to insert the needle in a way that is the most gentle and most accurate, etc. While working in a hospital, I found it helpful to frame things in language the nurses could identify with.  

With mothers I would use a different analogy, like learning to play an instrument - no one sits down and plays Chopin the first time they touch the keys - or riding a bike, learning to type or even putting on a diaper.  It takes the pressure off to know they don't have to "get it right" the first try.

Cindy Garrison BS IBCLC

> Date:    Mon, 26 Nov 2018 13:52:41 -0500
> From:    Julie-Ann Toalston <[log in to unmask]>
> Subject: Re: Can Lact 2 be hastened?
> 
> Thank you for those responses. I'm glad to be armed with more evidence
> supporting early hand expression!
> 
> I work in a hospital environment where most staff turn to the breast pump
> at the first suggestion of breastfeeding difficulties. I regularly see moms
> on the second day who have pumped every 3 hours for 24 hours or more
> without removing *any* milk whatsoever, because no one coached them through
> hand expression! (Can you guess whether their babies were supplemented with
> artificial milk?) That is not ok, especially when the solution costs
> nothing and is literally under our noses.  I'm doing what I can to
> encourage a culture of hand expression, however, my hospital is not Baby
> Friendly, and many nurses are not aware of what a difference it can make.
> There is also the fear (even from some IBCLCs) that when mom practices hand
> expression, she will not see any milk expressed. (There are many factors
> influencing the flow of colostrum, as we know, but that is no reason to
> skip teaching hand expression.)
> 
> Can any of you share ideas or lessons learned for encouraging staff to
> promote hand expression? Thanks in advance.
> 
> Julie-Ann Toalston, IBCLC
> Connecticut, USA
> 
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