Thus far I have not seen a post addressing the fact that breastfeeding is a 
hormone-driven process.  I have seen some pretty good milk 
production/maintenance in moms who do as much KMC as possible when they 
are with their SCN babies.  I encourage moms to go down to the nursery and 
spend time (preferrably s2s) with their babies, then return to her room to 
pump. They can pump at baby's bedside if they want, but there isn't a lot of 
privacy, so most prefer their room.  Virtually all of them report that the 
pumpings they do AFTER visiting the baby produce a larger milk volume.  I also 
encourage them to take a blanket that the baby has been wrapped in and 
drape it around their neck while pumping, so that they get the "baby smell".  
Many of our SCN staff encourage a mom to pump BEFORE visiting baby and 
then bring the milk down for the baby.  After discharge, I encourage them to 
put baby to breast (again, preferrably s2s) when they come in and pump 
between feedings - most of our moms are able to come for a feeding and stay 
thru the next, which leaves them time to pump at the bedside.  At night at 
home, I encourage moms NOT to set an alarm at night.  It's been my 
experience that few moms sleep thru the night while their baby is still 
hospitalized.  When they naturally wake, I ask them to get up, phone the 
hospital, talk to the baby's nurse for a few minutes, sit down and pump, and 
go back to bed.  The phone call gets them to thinking about the baby.
If a mother can do things to maximize her hormone output, the milk production 
will follow.  And with as much s2s as possible, baby's interest in nursing 
increases, as well as his organization at the breast.


Pam Hirsch, BSN,RN,IBCLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL    USA

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