I appreciate the skeptics' points of view. I do think the best idea is to save the pumps for needy families who present with a definite need for a pump. If you want to be a purist, however, there would NEVER be a need for a pump. Mothers can hand express for any infant and in any situation, so why would one ever use or recommend a pump? The reality is that pumps are a part of the culture, and they are thought of, by many, as necessary for a working breastfeeding mother, or just one that goes out and about. I do find them quite useful in many cases, but I think the mothers push for them much more than the bf supporters. In breastfeeding classes, and on breastfeeding rounds, pumps and pumping are a very common question and concern. Also bottles. One cannot simply nor easily change the culture and beliefs entrenched in a region.
Here's some examples from my practice. An immigrant mother had bf her first baby x 18 mos (she exclusively bf first months). Now she is in USA. She has to work in a factory but will have 3 months off. She began in hospital to give bottles during the day but bf at nite. She could not be dissuaded from this. She came for a followup at 4 days postpartum. Her milk supply was somewhat low. One nipple was cracked. The mother was alternating a bf then a bottle feeding 60-90 ml's formula; when baby bf she only bf 4 minutes each side. It was recommended that she exclusively bf (with followup) at least during the maternity leave and then wean gradually during the 2 wks prior to her return to work. She insisted she could not express her milk at work. She was very resistant to this plan, fearing baby would not take a bottle. She felt it was extremely important that baby take a bottle. She agreed to bf if she could pump every day and give one bottle. She would have been a great candidate for a free pump. I didn't have one but mom is to get one from the WIC program here (nutrition program for low income families).
Another mother came to bf classes and had lots of encouragement to bf. She just couldn't bring herself to do it. She had decided not to bf at all. I talked to her a bit and got that she just didn't like the idea of it. I offered that she could pump the milk for the baby and she brightened up and was interested in that. It is possible that this was an abused women or maybe just a typical Mississippian who thinks bf is gross. I don't know, but I don't think she would have liked to hand express. Here a pump was a good idea, I thought.
I had another mom whose baby bf well at birth. Later he wouldn't latch, she said, and he got 3 bottle feedings in nursery that night. Next morning he was circumcised and would not eat at all. The baby was placed skin to skin for a time, and didn't cue to feed, was spoonfed some expressed colostrum. Mother could not be dissuaded from a pump, which I call the "middle man" and asked for a pump and continued bottle feeding for now. Really, the LCs and the WIC bf specialists actively encourage direct bf, but the moms want the pumps.
Laurie Wheeler, IBCLC, MN, RN Mississippi, s.e. USA
_________________________________________________________________
Get connected - Use your Hotmail address to sign into Windows Live Messenger now.
http://get.live.com/messenger/overview
***********************************************
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 email list is powered by LISTSERV (R).
There is only one LISTSERV. To learn more, visit:
http://www.lsoft.com/LISTSERV-powered.html
|
