Recently I have been hearing staff nurses and occasional MDs on the OB
floor where I work telling mothers who are separated from their babies
(babe in NICU, lifeflighted to bigger hospital, etc), "The more you pump
the first couple of days, the faster your milk will come in."  I have done
numerous checks for research supporting this and cannot find any. The
Auerbach/Riordan and Lawrence texts say that prior to lactogenesis II, milk
supply is hormone driven (fall in progesterone after delivery of placenta)
and after lactogenesis II it is suckling and removal of milk from the
breast.
    I am not against pumping, I simply want to give accurate information.
For example, last week a primip delivered a baby with some problems.  He
was NPO for 24 hours.  Mom had been told by MD to pump specifically to get
her milk in sooner.  Mom was exhausted.  In the 24 hours she pumped she got
maybe 5 ccs colostrum which was lost in the tubing, baby never did get it.
It seems reasonable to me that this mom would have been better off not
pumping since 1. pumping will not hasten the onset of lactogenesis II and
2. Valuable colostrum can be lost (why was colostrum lost?  Busy, busy time
on floor, staff not always able to be one on one with moms for pumping
sessions).
    Am I off base? Please mail responses to [log in to unmask]   altho I
will try to check here as well.  Thanks in advance for any information.
                               Pam Bartholomew RN, IBCLC

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