I agree, Kathy, that expressing to relieve fullness is an intervention.
Expressing/pumping should not normally be necessary in a healthy, fully bf,
term baby who is feeding well and thriving, and feeding ad lib.

Many mothers will occasionally (or even more often)  experience fullness in
one breast or the other after the baby has come off the breast
spontaneously, and seems unwilling to feed more. Here, the mother is
encouraged to offer that breast first next time - and if the baby is truly
feeding *ad lib*, and the mother and the baby are close to each other *day
and night*, and there are *no bottles*  that next time may only be a short
time away.  The 'problem' solves itself...

If the mother is in great discomfort from full breasts, she is encouraged
to wake the baby and feed him.  Very occasionally, gentle hand expressing
is suggested,  for the few mothers who already have masses of milk on days
2-3 and a baby who doesn't yet want to feed a lot....but who may well do
tomorrow, of course.

I have posted before about this, and it has been confirmed by colleagues,
early days engorgement is not a major problem in the UK. In fact, we hardly
ever see it any more.  If it happens, it is usually over very quickly, with
the measures taken above.


Heather Welford Neil
NCT bfc Newcastle upon Tyne UK

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