Since we're talking about c/sec moms, I have to say that I disagree about a
few things that have been batted around. First, many c/section moms ARE
fully able and willing to nurse their babies on the delivery table. As much
as I'm for scientific data, I tell you that I have personally had 3
unplanned c/sections (the first after 48 hours active stage, the second
after 40 hours and the third after only 10 hours). Each time I've nursed
immediately with the help of my dear husband. By number 2, he really knew
the routine. It's not that I had such great sections, for two I was puking
everywhere, but I HAD TO DO THIS. It also helps to have babies that are at
least full term and truly mature (mine were 42, 42, and 40 weeks). I've
helped many c/section moms immediately after birth and found that if we put
in the birth plan AND reiterate NOT to give sedating anti-emetics, it really
helps. Having a third arm helps too.
Now, onto the next issue...we've had many a discussion about rushing to
latch babies on. In many, many cases of long labor, neither the mom nor the
baby is ready to nurse and that is perfectly okay. Babies do not absolutely
have to nurse immediately upon delivery. Is it nice, yes, but not
essential. My firm belief is that adding technologic gadgetry--including
the world's best breast pump--can undermine a mother's self-confidence in
her ability to bf. Most mothers I've seen pumping in the first 48 hours
will cry because they can't get what they perceive to be a normal amount of
"milk" or even colostrum. This is very demoralizing for them. In these
cases, I see it as far better to tuck that baby in with mom skin to skin
with someone in attendance to help her and make sure things are okay. Let
them both sleep and in a few hours try again. Although we think of early
postpartum as that golden "window of opportunity" we also have a cusion of
time. Most babies will actually choke and/or vomit if given large vol
feeds (I know that's not what anyone's suggesting, but I'm making a point).
I believe it was Jack that actually quoted one of his med school text books
awhile back saying that it was forbidden to give any baby formula in the
first 12-24 hours after birth because it had been shown to make them sick.
Yes, we are all very concerned about babies becoming dehydrated, but we must
really consider what message we are giving moms when we immediately hand her
a pump, and then when she does comply, she gets dribbles. The other danger
is that moms really turn up the suction and then cause edema, which in turn
makes it harder for baby to latch, which then leads to engorgement, tears,
etc. If we really need to pump colostrum, I am very much in favor of having
all moms taught the Marmet technique of hand expressing to help them become
more comfortable with their breasts and with manipulating their breast
tissue. I had found that very few moms can "naturally" do this and pictures
don't seem to help much. I actually have to show the mom on her own breast.
This usually results in someone being squirted because I'm pretty darn good
at getting milk out of a stone. Then they say "wow, how did you do that?"
and I show them again. Then I teach them how until the "get it". "Give a
man a fish and you feed him for a day. Teach a man to fish and you feed him
for life." Sorry to disagree once again, but we don't need to be hooking up
moms right and left to pumps. Yes, they are useful and boy am I glad we
have Medela and Hollister, but I think we go too far sometimes and sometimes
it's because of financial incentive (not saying ANYONE on our list, but I
see it all the time where LCs insist that moms need a pump and that LC makes
most of her money off pumps).
Just my 80mls.
Warmly,
Chris
--Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
€€€INFANT CUISINE AND MOTHER CARE: LACTATION CONSULTING & PERINATAL CARE€€€
mom, wife, active UU church member, educator, lactation consultant,
homeschool mom, researcher, scientist, author, organic gardener,
photographer, wilderness adventurer, lapidary creator, lousy cleaner;)
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