Wendy writes:

<Also mothers do not realise that  the let-down reflex works much more
effectively when the baby sucks direct with skin-to-skin contact.  I then
hear them say: I pumped for ages and only a few drops came out.">

I agree with Wendy that despite the advantages of milk directly fed from the
mother, in addition to those mothers who have no alternative but to pump
because of their working situation, there always seem to be those mothers
whose way of thinking and responding to pressure from their support system
leads them to think of the breast as an inert container with a "tap" to turn
on, via a piece of technology so as to collect a volume for the
"convenience" of indirect feeding, usually by another relative for "bonding"
etc.


(I had a mother today who called at 36 weeks pregnant to see if she could
start pumping now so as to have enough milk collected, because she plans to
"keep right on going to college class without time off when she gives birth,
so she can finish the semester!" And this is her second baby, first to
breastfeed!)


It is also easy for professionals, both in their understanding and in their
explaining, to fall into this trap of thinking of the vacuum from a pump as
if it were a straw in a soft drink, not realizing the vital importance of
the MER in milk transfer.


I have come to make it a first priority when phone counseling new mothers,
or issuing a breast pump,


   1. to make sure they understand about "the wonderful 'internal
   pump' built into the breasts by mother nature, to signal the back of the
   breasts to 'squirt' milk forward now and then so the baby's mouth can reach
   it easily" and that
   2. this is the most powerful force in milk transfer and that
   3. unless it is triggered, the external pump will not be able to
   remove much milk from the breasts.

And it is my experience that in any stage of lactation, RPS applied firmly
to the central areola for 60 seconds seems to elicit an MER without fail
within another minute or so, even if a mother is under any sort of stress.


Many of them never dream of using massage and/or breast compression
intermittently during the pumping unless someone suggests that it helps
increase the volume and speed of milk removal.

Jean
*************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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