Alicia Dermer wrote:
>As for this problem, it would be nice first of all if mothers could be
>taught about this in prenatal breastfeeding classes, so that they come
>in with the expectation of expressing colostrum if their babies can't
>nurse, and their support persons (husbands, grandmothers, etc, could be

>educated about the importance of this and help to support mothers to do

>this).

I can't agree with you more, Alicia. We do teach this to our Newborn
Care Groups (32-36 weeks of pregnancy) when we talk about breastfeeding
after C/Section. I can't say we're there yet as an outcome as we don't
always have the staffing to recover both mother and baby after the
surgery but we're working on it. At least if babes and moms aren't
together after the surgery, dad or other support person can stay in the
nursery with the baby. No formula is given (we don't give formula to
breastfed babies without a doctor's order for medical reasons) so
there's more motivation on everyone's part to get mom to express.

What concerns me more is why these moms are so out of it. It's easier to
use my own experience at the moment. I delivered by C/Section for
failure to progress (CPD?) 15 years ago. As a nurse who knew what was
happening, I really didn't want to be awake. However, I'd already had an
epidural when the decision for surgery was made and there was no way
they were going to give me general. I kept saying to the
anesthesiologist - a wonderful woman who was very kind to me - "put me
out, please just put me out." So she did her best with as much IV
morphine as she could. It didn't help because it didn't put me out - at
least not during the section - but you should have seen me after. I
literally could not fully wake up the entire evening through the next
day and to the morning of day 2! Yes, I did get out of bed but I
honestly don't even remember if my daughter was brought to me. She was
certainly getting formula.

Luckily for both of us, when I put her to breast in an awkward position
for the first time ~ 42 hours after delivery, she latched on like a
champ and barely let got for 2 years!

I didn't know it at the time but my daughter's father told me that there
was another woman who was in the recovery room after her C/Section at
the same time as I was. She'd had an epidural and nothing else. Her
husband was with her helping her nurse her baby. He was amazed at the
difference between us (I almost shot him for telling me) but it really
is possible.

So I wonder, why are so many women so out of it?

Joan Edelstein, DrPH, RN
Professor of Maternity Nursing
San Jose State University
Perinatal Education Coordinator
Kaiser Permanente, Hayward

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