Melinda writes:
 
 
<<I am so interested in this.  Jan, do you know where I  can find the Geddes
study?  I continue to find that a high percentage  of mothers can obtain 
this
bolus even if they cannot pump until after the  first hour.  A mom recently
was too ill to pump until right about 24  hours after birth, and she still
was able to obtain almost an ounce of  bolus.  We very rarely are able to 
get
our NICU moms pumping in that  first hour, but I've gotten very used to
walking in a room and having a mom  exclaim that she got "a lot" with the
first pumping (which could be  anywhere from 3-6 hours or longer after 
birth)
but now is only getting  drops. so she gets lots of reassurance and teaching
of hand expression and  "hands-on" pumping!>>

 
I'll have to see if I can lay hands on the study.  With my  organizational 
skills (not) it may be awhile.  Meanwhile, I'm totally  fascinated by the 
fact that your moms get so much 3 to 6 hours later (or a  goodly percentage 
do).  And Nikki, do you know when they did the first pump  vs hand expression 
in the Oyama study you cited?  That would be interesting  too.
 
I think the whole thing would make a marvelous study, and don't know why  
someone hasn't done it.  I haven't actually worked in the hospital since  
2010, and at that point, was only a "visiting" LC for a group of pediatricians, 
 so didn't have the opportunity.  But I have it all laid out in my head if  
someone is interested.
 
Things to look at:
 
1.  Type of birth (induced, stimulated, repeat C/S, in labor on own  
culminating in C/Section, normal spontaneous vaginal delivery -- do they have  
those any more?)
 
2.  A group of women doing only hand expression starting at 1  hour
 
3.  A group of women doing only pumping starting at 1 hour
 
4.  A group of women doing only HE starting at 6 hours
 
5.  A group of women doing only pumping starting at 6 hours.
 
Is anyone else seeing the large boluses that mothers are getting later on  
down the road as Melinda is?  I never did -- but as a "visitor" I didn't  
see everyone.  Nor did I keep track of those I did at the time in term of  how 
much they pumped/expressed.
 
In the Parker article the moms that pumped at 1 hour got an average of 4.19 
 ml (not my 10-20, but these were moms of VLBW babies, and I have no idea 
about  their births).  Moms that pumped at 6 hours got an average of 0.1 ml.  
 And that is where I know they would have gotten more had they done hand  
expression at 6 hours.  I don't think anyone has looked at pumping within  
the first hour on a big scale and looked at any of the parameters.  
 
Jan Barger, RN, MA, IBCLC, FILCA
Lactation Education Consultants
Wheaton IL
 
 
 



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