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Subject:
From:
gonneke van veldhuizen <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 12 Feb 2010 00:09:38 -0800
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I must have missed something. I did not know that vacuum was a prerequisit for full milkejection. If so, how come moms can easily and often even better hand-express than pump? 

Warmly,

Gonneke, IBCLC in PP, LClecturer, wondering in southern Netherlands

--- On Thu, 2/11/10, Kershaw Jane <[log in to unmask]> wrote:

From: Kershaw Jane <[log in to unmask]>
Subject: Re: [LACTNET] breastmilk supplementation
To: [log in to unmask]
Date: Thursday, February 11, 2010, 11:19 PM

If you believe the research on let-down which shows that if there is not adequate vacuum on the nipple, when the milk lets down, it 'backs up" into less full areas and is less available on the next let-down, this would make perfect sense.  If the baby doesn't have enough vacuum, then he won't get as much milk as possible from the first let-down and the less milk obtained (percentage-wise) of total volume, the less total will be obtained of available milk. Did I lose you there?  So the advice to express BEFORE nursing might actually work better than expressing after.   

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of laurie wheeler
Sent: Wednesday, February 10, 2010 10:12 PM
Subject: breastmilk supplementation

In my experience, the babies that truly need supplementation (meet medical
criteria) are also not sucking well. So I think it makes sense to have mom express prior to the feeding. If baby was latching well, the supplement could be given via lactation aid while baby was doing his breastfeeding.
In my experience also, the mother often does not extract enough colostrum for the amount prescribed by the doctor to feed infant. So formula is given.
In my experience, many mothers don't express when asked to or not often enough. Not sure why but can think of several reasons, one of which might be lack of continuous access to supportive staff, including the fact that lactation staff are doing inpatients, outpatients, and are not there 24/7.
In my opinion, if baby was kept skin to skin (a practice not used nearly enough in our hospital) the amounts extracted would likely be increased, and the need for colostrum would likely be decreased, a win-win situation.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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