Cathy,

You made a good point about sharing our clinical experiences - one of the
great raisond'etre for Lactnet and JHL.  It is our clinical experience that
then leads to research that may eventually confirm and quantify it.

With the studies that Dr. Hartmann has done, I have added much more hand
expression or pumping for moms with low milk supply - when the baby has
been an inefficient nurser.  In other words, if the milk supply is low and
I have just met the mom and observed that the latch was incorrect and I
helped her work on it, I also add pumping after feedings - because 1) she
can feed the baby her own milk rather than formula 2) I don't assume baby
will suddenly "get it" and be totally efficient at milking the breast
correctly, 3) in my observations the increase in supply and flow often
increases baby's capacity for good nursing movements.

However, I would NEVER suggest that pumping without the baby at the breast
(unless he/she were unable to) would be better or more efficient than the
combination.

In the OLCA Presentation in Ohio, Dr. Hartmann also advocates skin to skin,
with numbers to prove the increase in milk production when skin to skin is
stressed.  So - he did NOT say NOT to put the baby to the breast!

As his team has such striking data on milk removal, milk replenishment,
etc.  People tend to report this more than the other message (skin to skin)
- but I never heard him in any way suggest that babies should be replaced
by more efficient ways of removing milk!

Jeanette Panchula, BSW, RN, PHN, IBCLC
NEW E-mail: mailto:[log in to unmask]

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