> Date:    Sun, 5 Feb 2006 23:28:32 -0800
> From:    Ellen Steinberg <[log in to unmask]>
> Subject: Infant feeding requirements
>
> Regarding my case of the 5 month old who did not gain weight due to
> inadequate intake, Rachel writes:
>
> I note with some curiosity that this mother had a supply of  
> expressed milk
> socked away in the freezer.  Ellen, do you know why that milk  
> didn't go into
> the baby when it was produced?
>
> Mom had been stockpiling some milk because she is going back to  
> work next
> week.  I believe that one of the reasons why her milk supply had  
> decreased
> is that during many feedings she was breastfeeding on one breast  
> and pumping
> the other so that she would have some milk stored up in preparation  
> for
> going back to work.  What she didn't realize when she started this  
> routine
> is that her milk supply was not sufficient to both feed the baby  
> and stock
> the frig.  And, as a result, the pumping may not have been as  
> effective as
> the baby so her milk supply decreased.  Also, although this baby  
> seemed
> clinically strong and healthy, it is possible that the decreased  
> caloric
> intake he was receiving may have resulted in less energy so that  
> even his
> suckling was not as effective as before.
>

I have a question about this.  I feel like I may have routinely been  
giving out poor information to mothers planning to work outside of  
the home and want to understand and get my information straight.

My usual suggestion to a typical mother who is planning on going back  
to work after her typical US maternity leave ( 6-8 weeks - we won't  
go there now ;->) is to focus on getting breastfeeding going well and  
enjoy her baby for at least the first two weeks.  After that, if  
everything is going well, and she can coordinate it, I suggest that  
she can pump on one side while she feeds the baby on the other.

My rationale is that otherwise I hear about mothers trying to figure  
out when to fit a pumping session in between feeding the baby.   
Often, when trying to fit a pumping session in she only gets a very  
scant amount (enough cover the bottom of the bottle) - at that point  
a get a call from a freaked out mother worrying about whether she has  
enough milk to feed her baby and what is she going to do when she has  
to go back to work/school (Go Gators ;->).  At this point I have an  
exhausted, stressed, and resentful  mother who feel as if she is  
either hooked up to the baby or hooked up to the pump 24/7.

When a mother with a "normal" supply of milk pumps while  
breastfeeding she can use her body's response to be able to pump an  
ounce or two of milk.  Many mothers, when they go back to work/school  
feel more relaxed and confident if they have a small stock pile of  
milk in their freezer.  The more relaxed and confident they feel, the  
better they can pump when they are back at work/school.

So, am I full of ****?  Am I doing more harm than good?  Does this  
not make any sense to anyone?

Thanks for your responses!

Alicia Rudin, LLLL, RLC, IBCLC
[log in to unmask]
Gainesville, FL

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