Hi Susan,

I had a go at cup feeding my 4 mo nephew while I was baby sitting him last
thursday....I don't think either of us were very good at it but it was an
interesting experience! I'd love a in person demonstration! However, my
daughter's paediatrician worked in Papua New Guinea for a long time and was
emphatic about the appropriateness of only cup feeding in situations where
sanitation was not good!



> The one thing that I have not noticed (and someone may have posted this
before) in the posts
> about Hurricane Katerina is the importance of cup feeding, rather than
bottle feeding, when water
> and sanitation are poor whether it is human donor milk or formula to
complement the relactation.
> From my international perspective - the reason why I think cup feeding
became so popular as an
> alternative feeding device is that you can easily clean a cup and they are
readily available.

I agree with you Susan, I don't think it is really any different either but
it seems to be treated as different (read harder, less likely to be
successful) by many.

> Karleen had mentioned that some lactation consultants may not be as
familiar with relactation, but
> I have to say that if I really think about it with my clientele of which
only about 10% exclusively
> breastfeed (and I'm not even sure about that 10%) is that most of my job
is relactation - that is
> increasing the milk supply typically from iatrogencically or culturally
induced impediments to the
> natural course of establishing lactation.  Yes, one might quibble that it
is different when you start
> off with a supply that is at zero - but really I see this as only a matter
of degree.

I wonder why! When the mothers are relactating how often are they
breastfeeding for and how often and for how long are they pumping?? I can
see how in the early stages of relactation there may be some real advantages
to double pumping because of the difference in prolactin secretion but I
wonder....

> Yes, I totally agree that pumping has its problems in unsanitary
conditions, but I can see how it
> could be helpful once these women are in a stabilized center IN ADDITION
to putting the baby to the breast.  I always find it is faster to relactate
a mother using both at once.

Some interesting thoughts here. This research is done with mothers with
established full milk supplies, yes? Would it not be that babies remove what
they need/want, not what they are capable of removing? ie the pump doesn't
know when to stop and the baby does. I don't think that this relationship
would necessarily hold for situations where the mother's milk supply is
lower than what the baby needs and the baby is taking all that s/he possibly
can from the mother.
That's not to say that pumping may not be a useful accompanyment to a baby
suckling in relactation in some cases but I think that if the baby is
willing to suckle a breastfeed is better than a pumping session. Something
that I think is really important in relactation is that what the mum is
doing has to be what she can live with, pumping is hard! I relactated with a
pump, I know how difficult it is. Often I hear from mums in the US who have
been to see an LC and they've been told to breastfeed the baby (may be doing
it 8x a day) and that they should pump 8-10x a day as well. They end up
giving up or spending all this time with the flaming pump and not their baby
when decreasing the amount of supplement that they are giving at each
breastfeed and increasing the number of breastfeeds a day would be easier to
live with and just as likely to be just as good. The most successful
relactaters in the world are not Western women who have a stack of drugs and
breastfeeding supplementers and pumps it's women in developing countries who
have supportive health care providers, knowledge of breastfeeding and most
importantly they keep their babies close and BREASTFEED A LOT! I

> Finally, now I'm bracing for the flames with my asbestos suit for this
one, I have concluded that it
> is simply not true to state that a baby is alway more efficient than the
pump.  Babies who are
> sucking well are MORE PHYSIOLOGIC at stimulating an appropriate milk
supply for their needs.
> But I still remember Peter Hartmann's talk from the prevous year's talk at
ILCA about how babies > drained the breast to about 50% capacity and the
pump drained it to about 80% capacity.  What  that told me was that a half
drained breast is physiologically appropriate when all is going well,  but
when a mother does respond to the pump and has a low supply, the pump IS an
efficient tool  and for many women may very well be more efficient than the
baby in bringing the supply up.
> This is particularly true for newborns who may normally take 50 min or
more to finish a feeding.
> When mom has an iatrogenically induced low supply, the pump can drain the
breast in 10-15 min.
> In these instances, the pump is more efficient than the baby - but is no
substitute for the skin-to-
> skin contact and the breastfeeding practice that will eventually make
feedng at the breast
> possible.

Bottom line for me....I think that pumps can be useful if the baby is not
willing to suckle frequently but if they are I think that they can perhaps
do more harm than good. Gosh we need some research in this area!

Karleen Gribble
Australia

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