dear nancy and all,

consult your riordan and auerbach, pg. 453, beyond that, do some research and
tell me it doesn't make any difference . there's a study out there (or more)
showing milk lipid level differences following massage, too, but i am not
going to go look for it. someone can find it and tell me how bad it is or
poorly substantiated and i will take a look and be willing to change my mind.

of course we shouldn't expect stressed out moms to do it correctly! pump for
fifteen or twenty whole minutes? gosh! so i guess that means if someone has to
have chemotherapy, and they are too stressed out to take the whole course of
treatment,  or maybe if they are feeling poorly physically, we should say,
well, that's asking too much, just quit.

why would we not do that? because of the risks. why would i not tell a mom to
give up  on pumping if she asks for my professional opinion? because of the
risks. every hospital i have been in so far is just waiting for the slightest
hint of an opportunity to feed abm to babies without the slightest
consideration of the risks involved. heck, they do it all the time without any
justification, anyway. it is crucial that mothers be well informed about what
should be done when pumping. it is like all other aspect of caring for their
preemie. then THEY WILL CHOOSE what level of compliance they will operate at.
it is the mother's choice. paternalism won't cut it.

and it is much harder to call me up and shell out a lot of money and have to
really make a huge effort to boost a poor milk supply four or six or eight
weeks out, when some teaching and support in the beginning would have ensured
the mother had a good milk supply.

and then, too, i could avoid having to hear stories like the one i heard
today. mother nearly died, is lying on the delivery table, and the nurse who
was particularly annoyed at the mother's insistence on breastfeeding without
supplementation, tells her gleefully, "well, you KNOW he will have to have
formula!"

subtext alert here if you have missed it is, your baby will die if i don't
give him formula because you don't have any milk. the baby got a bottle first
thing. and the suckiest part is that just a couple of floors below this
operating room is the mother's milk bank, with freezers full of donor milk.
tell me the name of the alternative universe.

carol brussel IBCLC