I am another hospital based IBCLC who notices much more volume (or evidence of transfer) in the first day as opposed to following days. I would love to see a study on this.  Following along on this subject, I am wondering about pumping volumes for our tiniest infants.  When premature babies are too unstable, they are transferred directly to special care.  Our policy states that a pump must be set up within 6 hours of delivery.  I am not sure where the 6 hour time frame came from.  We also teach hand expression.  There is a lot of push back from staff that they cannot pump any earlier than this because the patients are too unstable or, probably a more likely reason, the nurse is too busy.  Does anyone have research on the effect of pumping earlier than six hours or even where the six hours came from?  What do you do in your hospitals?
Thanks,
Polly Westra R.N., IBCLC

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