Having seen my share of miracles - babies who were not expected to live,
but did - I go to the moms and talk about what they had planned to do
before the crisis.  If they had planned to breastfeed, I encourage them
"strongly" to pump.  I say strongly, because at times (depending on how I
see the situation and the mom), I am the only one making demands of the
mom.  Everyone else is tiptoeing around her and wanting to "comfort" her.
The comforting more goes into the realm of medicating her or at least
encouraging her to "rest" all the time.  However anyone who has ever been
in this situation knows you rarely feel relief even after medication and
sleep is rarely long or restful.

My suggestions are:
Pump q 2 hours that you are awake, and at least 1 at night - and total 120
minutes
Know that your milk supply will be 0 for the first three days (then they
are thrilled with the drops or even cc's they do get)
When breasts start making milk, the supply will change depending on the
situation with your baby - when baby has crises, you milk supply will go
down - but keep pumping and the milk will go back up when things get
better.
Use warm compresses prior to pumping, or drink water or whatever "trigger"
will be most easily reached when you are home - or even at work.

The moms I have worked with felt they were glad they had pumped even when
their babies did not survive.  One mom even had me take her milk  to a milk
bank in the US when her baby died after two months.  Others have donated
the milk "informally".

Those moms whose babies did survive felt they had been part of the cure and
recovery.

On Monday I had a mom whose baby was NOT in critical condition, but she
wanted me to give her a pump so she could pump at night and not have to go
to NICU as she was very weak and tired with a cesarean.  I got her the pump
(a roll-away pump we lend without cost to hospitalized moms) and the kit,
but did not open it - just put the bill on it.  I told her how to use the
pump, but stressed the importance of her going to the baby and
breastfeeding him.  In the morning, I went back to find a mom who was
walking well and had not opened the kit - she had breastfed all night.  She
was grateful I gave her the additional "push" she needed to go to her baby
at night.

It is really an art in recognizing who need the extra push - and how to
give it.  But in general I find that we need to be the "cheerleaders" and
think positive.  Baby WILL live and need your milk.  You WILL be able to
pump, and I am here to help you.


Jeanette Panchula, BSW, RN, IBCLC, LLLL
mailto:[log in to unmask]
Project Director - Proyecto Lacta - Puerto Rico
http://netdial.caribe.net/~prlacta/
Lactancia Materna '98 - La Mejor Inversion