Hi, Wendy:  Interesting that I should see your post today.  I just sent a 
mom home yesterday who was born without her right forearm and hand.  Her 
arm ends just below the right elbow.  She wears a vinyl prosthesis that 
allows the hand some pincer grasp, but that is all.  She is not able to 
pull her arm/prosthesis into her body very far.  She needed minimal help 
with positioning her baby.  The system that seems to be working for her is 
for her to use cross cradle or side-lying on her right side.  Baby seems to 
understand even this early on that he needs to co-operate and help his mom 
to help him.  Thus far she has no other issues and I anticipate that they 
will do well with nursing.  I did suggest to her mother that she buy her 
daughter a sling so that she can have her hand free to do other tasks.  It 
was a pleasure working with this family and interesting as well. Mom breeds 
horses for a living and is planning on returning to work when her baby is 2 
months old.  He will be able to go to work with her, so she does not 
anticipate having to pump very much.  We discussed using one of the hands-
free bra devices for the times she will need to pump.  We also discussed 
lactation in horses and she told me that the minute the foal is delivered 
the clock starts ticking - if the foal is not to it's mother's teat and 
receiving colostrum by 3 hours the foal will die.  She always keeps frozen 
colostrum on hand for those foals that may need it.  She breeds expensive 
racehorses, so there is a huge financial incentive to get horse babies to 
their mama's "breast".  I reminded her that she already knows all about 
lactation and the process is very similar for her and her baby.  I have her 
permission to share her story with you.
I did post this before, but an excellent resource for helping parents with 
disabilities is Through the Looking Glass (www.tlg.org).

Pam Hirsch, RN,BSN,CLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL   USA

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