And part of this research needs to be the type of pump used, the length used, the method used and whether it's done hands-free (for the pump) plus hands for massage. IN our hospital, we commandeer the used fetal monitor belts, cut holes in them and make them into cheap hands-free bands by putting the flanges through the holes and tying the ends together. Works great for moms especially when they are pumping in bed. Not as useful when milk starts coming in more but great for tired moms!
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Jan Barger
Sent: Sunday, October 06, 2013 5:05 PM
Subject: Bolus
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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