Mary:  Lots of the "LCs" (not necessarily IBCLCs) around here seem to
believe in that 6 hour rule of pumping (as though it were a religious
tenet).  Personally, I think pumping this early is actually distruptive as
it can both undermine mom's confidence and can cause inflamation.  IMNSHO, I
give 48 hours of repeated responding to the baby's cues, lots of skin to
skin contact (yes, taking mom's shirt off even in the hospital) and mega
amounts of patience and faith that the process works most of the time
without gadgets.  Just having baby rub up against nipples repeated, perhaps
licking here and there, appears to be extremely effective.  (Of course we do
lots of things to muck this up with drugs, separation, even clothing, etc.)
IF this hasn't worked (and if I'm there early, no bottles have been given,
etc., it almost always does), then I resort to pumps or other means unless
the mom is showing signs of very early engorgement.

 One thing, among many, that my past years of LLLI involvement taught me was
to have faith in women's bodies.  When WE have faith, it rubs off on moms
and other hcps.  I cannot tell you how many times I've had hospital RNs say
"that mom will never nurse" (yes, in front of the moms) and we've turned it
around.  In those early hours (up to say 48 hours) we have the luxury of
learning to "dance".  I just cry when I see people hitting the panic button
so early and starting that downward spiral.  There IS a time for
intervention,  but I'd have to see some serious data before I'd think it was
at 6 hours.

Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC    [log in to unmask]
mom, wife, educator, lactation consultant, researcher, author, organic
gardener, photographer, lapidary creator, lousy cleaner.

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