Today I did my first in-service ever on manual expression.  It was very busy
on the ward so only 3 staff showed up, but I would call it an unequivocal
success.  I got a volunteer from the women on the ward - the first person I
approached, in fact, and she jumped at the chance because she wanted to
learn how herself.  (Of course I would have shown her even if she didn't
offer her services for us to practice on!)

It took about 15 minutes - I explained when manual expression was useful,
and then showed how on my cloth model, and then showed the mother by placing
my hand over hers and helping her get the position and the movement right.
She is 3 days post partum but who hadn't observed milk dripping out yet.
Her delight at seeing how easily it started flowing was nothing compared to
the excitement of my 3 colleagues, (2 childless, one with several children
but not great BF experiences) when they were allowed to try their hands at
it.  All of them succeeded easily and felt it had been immensely useful -
they had never felt sure of themselves before and I think it hadn't worked
so well.  We aren't taught this in school and if you haven't learned it by
doing it yourself, there really isn't much opportunity to do so unless you
really seek it out.  Reading about it just isn't good enough, any more than
it is enough to read up on labor or breastfeeding.  It helps, but it's not
enough, or even necessary.  The hands-on is essential, esp. if you are going
to teach it to mothers.

The plan is that a core group of staff will be approved by me to check
others' technique, and we will see to it that all maternity staff have
guided practical experience with a return demo to show they have
satisfactory technique.  After the success of this pilot session I am
hopeful that we can have a large number of dairymaids ready to go by fall.
I think it was good that so few people were there, although the mother said
she was prepared for more people to be present, if not to practice on her.
I wouldn't have asked that of her if there had been more people there.

One of the staff asked the mother if she felt it was unesthetic to have
someone demonstrate manual expression on her.  She replied that after what
she'd been through in labor, this was nothing! - but she didn't think it
would have struck her as unpleasant before either.  I noticed that nobody
minded getting milk on their hands, just rinsed them afterwards.  We don't
seem to consider it an unclean bodily secretion.

Had to share this as it was a high point in a pretty good day all around.
Rachel Myr
Kristiansand, Norway

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