I tell moms to breastfeeed on one breast and pump the other at only one
feeding...the morning one is usually the easiest, but any time will do. To
finish feeding on the side they pumped, and to switch the sides every day so both
sides can respond to the extra removal.
I am having a very hard time understanding why pumping extra milk is an
issue. I fed twins, one each breast so how can it mean less milk will be
available if you pump one side and nurse the other? This topic is always coming
back to Hartman's research, and I am always thinking the same thing....these
women were NOT trying to increase their milk supply. What if they were? What
if they were feeding and pumping and feeding and pumping, would not the supply
increase? Why is it that we have now decided that what a mother makes is a
constant unchangeable amount? And, in terms of exact numbers is that even
what the research showed? Maybe there were variations of a small amount, but
not enough to be considered 'statistically significant', but still it was
there.
And, as long as I am thinking of this, I will add that I am fairly sure
consumption increases and/or varies also. Sure, growth caloric needs slow down,
but how about caloric needs for activity? I have yet to have 5 month old
that is not busy moving. What about the older baby crawling and walking? My
babes walked by 8 months and only a couple were even tasting food then. I do
not think my supply dropped. How long was the study continued? What is done
through the first two years? If not, how do we know for sure that breast milk
was not available in a varying quantity after the 6 months? Maybe it
changed a bit when solids first started, but then rebounded for those picky eater
days. I know my 1 year olds would sometimes refuse to eat anything at all!
Thank goodness they had my milk.
I think that we are talking about different issues when we talk about
ability to produce milk as needed rather pumped or removed by the baby. Some
women schedule feeds around the clock, others don't schedule and instead follow
baby's cues. This means that some women are consistently aiming to feed 'x'
number of times per day and others are feeding ad lib with the baby's whim and
desire. Would not that make a difference too? If a mom is consistently
expressing 2 ounces a feeding, why would her body not simply make 2 more ounces
a feeding if she were always allowing her baby to nurse without the clock
driving his feedings? And, actually, even if she was watching her clock, it
still seems to me her body would simply make the milk removed. It seems to me
that the idea of milk removal is the driving force for milk production would
apply.
Breastmilk continues to have more calories than solids and definitely is the
superior source of nutrients. I do realize that mothers replace
breastfeeding with solids, but that is not what is supposed to happen. Also, as along
we use the bottle feeding as the norm to mimic we are going to miss the whole
picture. Moms who bottle feed add to the bottle, remove a bottle, etc.
Sure, if they feed the baby two jars of food they are likely to not give them
that feeding's bottle. BUT, with a mother who is breastfeeding by the 'nursing'
definition (which means as needed and for more than food) and only offers
foods after nursing and is not aiming to eliminate breastfeeds I do not think
we will see the drop in supply.
I appreciate Hartman's research, but what he was looking at is not what we
are talking about when it comes to increasing supply. I would like to see the
same research being done for women who were actively trying to increase
their supply for their 2 or 4 or 6 month old. I still think if at 2 months women
no longer have the ability to increase their supply then we are all wasting
our time working on this issue with slow weight gain. Might as well say
'well, you have set your production and now must just use an alternative to
breast milk' and that is not what we are doing.
I do not think Hartman's research meant for the assumption to be that what a
mother makes cannot change. And, I am even less sure that it applies to
all women in general. I accept it is what he saw with the women he worked
with, but I think we have more to do before we assume that all women everywhere
reach a certain volume and are unable to increase it. The same is true I
think about starting solids. There are still babies who do not start solids at 6
months and even more who when they do start solids are not taking more than
an experimental taste and yet they continue to grow and be active. And, the
caloric needs for growth in the earliest months when all the baby really does
is eat and sleep cannot be that much more than the needs of a child who is
growing more slowly, but sleeping much less and much more active. Even using
an older child or the adult as measurement---those of us who are very active
can continue to consume calories and not get to be the size of the barn door,
but for those like me who consume more calories than we are using we do in
fact continue to grow...just not in height and head circumference.
This is just one of those evidence based topics that I think is still
missing all the evidence and that some of the evidence is interpreted differently
from one professional to another. If we used the evidence to mean milk
production is established by 2 months, then it makes perfect sense to have mothers
pumping and stockpiling for separation needs because that will simply set the
production level at a higher amount. And, it would make sense to start that
by the 2-4 week mark. Thinking of the overproduction of the early weeks as
the body is establishing need would be ideal for pumping and would tell the
body the need is great. Isn't that what happens when mothers have twins and
are exclusively breastfeeding? Every time I think of this I think of all the
women nursing on only one breast out of necessity and all the mothers of
multiples. No one is telling them they cannot make enough milk. Why is
expressing any different?
Of all the changes in lactation information I have had to absorb, this is
the hardest information for me to accept as the new absolute. I still hear the
mantra, the milk in the breast was not put there to stay, the more you take
out the more you make...or something simlar. Are we now adding to it with
"in a set amount that you cannot change".
I really like reading Linda Smith's comment on her web site that people get
PhDs studying this. At least I don't feel totally ignorant for not being able
to 'get it' completely. Haha.
Best,
Pam MazzellaDiBosco, IBCLC, RLC who is going to be sure to delay solids just
to watch intake after 6 months....not a biggie as I do not feed my babies
until closer to 9 months anyway.
***********************************************
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|