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Lactation Information and Discussion <[log in to unmask]>
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Fri, 2 Jul 2010 08:43:08 -0500
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I work in a hospital with a level 3+ nursery.  Right now we have several tiny babies born at 22-24 weeks gestation.  These babies have special beds for them, are on ventilators and other life support systems.  They are barely alive.  Please show me the evidence-based information that shows that these babies will survive placed on mom.  And let's be realistic, if indeed it is BETTER for these babes to be on mother (which I think it might be), what mom can sit in a chair 24/7 without a need to pee and eat and sleep?  Plus pump for her baby.  The research done has been on babies 32 weeks and above, I believe.  And these are small studies.  We can't forget that in the "wild" these babies WOULD NOT SURVIVE outside of the womb.  All of our technology is trying to create an environment that is womb-like in it's ability to provide warmth, nourishment and protection in hope of helping a baby survive.  And hospital personnel, including doctors, are not trying to harm the mother-child bond, they are just focused on keeping the baby alive and as healthy as possible with as few sequelae as possible.  We have a heavy emphasis on getting moms pumping, getting the colostrum and milk to the babies ASAP, touching and being with baby as much as possible.  Let's advocate for mom and baby but can we do it in a way that recognizes that most doctors and nurses CHOOSE to do what they are doing and have no ill will towards their clients.  I would challenge anyone who works with breastfeeding moms who have preemies to (if they have opportunity) tour a local NICU and see really tiny babies and hear the miracle stories.  The first lactation course I took as an aspiring consultant was with Marsha Walker and Jeannie Driscoll back in the age of dinosaurs.  It was so eye-opening to move beyond what I was familiar with(normal newborns) into the world of the long-term pumping mom.  This was before kangaroo care was attempted and Susan Luddington's work.  Things have advanced a long way in the years since.  

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Arie Brentnall-Compton
Sent: Thursday, July 01, 2010 11:30 AM
Subject: Skin to Skin is the normal paradigm

"I think that we need to be more aware of today's birth process and that A LOT of babies are unable to be held by the mother after birth due to extreme prematurity/illness. When this occurs we should not make mom/dad feel guilty for not being able to hold their babies. We should promote touching through the isolette and staying with baby as much as possible, but we can't say that the baby is being deprived due to birth situation.

When skin to skin is allowed,  then by all means we need to encourage it as much as possible, but if mother is unable to do so we should use pumping as a way for her to be close to her baby.

Julia IBCLC, RLC"

Julia, this statement concerns me because while it might reflect current practice, it does not reflect evidence based care.  We know that babies stabilise in skin to skin- it is not simply a nice bonus for the mother & baby, it is essential to the baby's health & life.  How about enabling parents to advocate for their baby, recognising that it hurts the mother & baby to be separated from one another?

--
Arie Brentnall-Compton
780.777.9525
www.tadpoles.ca
Breastfeeding & Babywearing Educator

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