The 6 hour time frame came from studies done in 2001.
Hill, P. D., Aldag, J. C., & Chatterton, R. T. (2001). Initiation and
frequency of pumping and milk production in mothers of non-nursing
preterm infants. /Journal of Human Lactation/, /17/(1), 9-13.
This is the study that found greater milk production in mothers who
began pumping within 6 hours of birth.
Jones, E., Dimmock, P. W., & Spencer, S. A. (2001). A randomised
controlled trial to compare methods of milk expression after preterm
delivery. /Archives of Disease in Childhood-Fetal and Neonatal Edition/,
/85/(2), F91-F95.
These researchers showed that simultaneous pumping after a very brief
breast massage (dividing the breast in imaginary thirds, placing the
fist on the top of each third, and rolling the hand down the breast so
the fist winds up palm side up) got more milk. I spoke with Dr. Jones at
an ILCA conference after this research came out, and she showed me the
exact massage they used, and explained that they did this particular
massage because they didn't want to skew the research by removing any
milk during massage.
Lisa posted Parker's study that we really need to be removing milk in
the first hour after birth to maximize supply. This is true also for
direct breastfeeding, the following researchers showed that in mothers
who initiated bf in the first two hours after birth, their infants took
54% more milk on day 4 than those who first bf later.
The more we learn, the more we appreciate that the breast is very
sensitive to milk removal in the first few hours and days of lactation.
Catherine Watson Genna BS, IBCLC NYC www.cwgenna.com
On 1/13/2017 11:02 AM, Westra, Mary wrote:
> 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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