<< We are starting to see mothers of newborns leaving hospital with a pump
(&
 a healthy baby) because they think a pump is necessary for breastfeeding.
>>

<<Or is it because the hospital lactation program is supporting itself by
rental of pumps and sale of other equipment???  Hmmm????  Because the
mothers
have been warned in the hospital-based prenatal bf class that they WILL
need
a pump for engorgement because it is (a) very painful and (b) everyone
experiences it and (c) the baby likely won't latch on so (d) they will need
said pump so (e) take one home now just in case it happens at 2:00 in the
morning and you will have one???  Hmmmm???>>

Ok, cynical Jan B. :-) and others, if the hospital has no monetary
incentive when giving out pumps, does everyone still think this is an awful
thing to do?  I'm willing to be convinced to stop doing this, because it
would save my hospital bundles of money, but let's look at the other side
of the story.  My place charges a "per diem" charge, which means we have no
charge slips on anything anymore, so whatever we give out cuts into our
profit.  We get the same $$$ per patient whether it's a bottlefeeding mom
who needed no special supplies, or a breastfeeding mom who got a
breastpump, Lansinoh, bra pads, and a Haberman feeder.

We offer a Medela manual pump to every mother, one of the reasons being (e)
above.  We do not teach that engorgement is inevitable, and preach "good
attachment and frequent feeding" in all of our teaching and written
materials, but reality is reality.  Some of these mothers are going to get
engorged no matter what we do, and I'd like them to have a way to deal with
it.  And maybe *I'm* cynical, but I think the chances of getting all the
nurses to teach hand expression is about nil.  The other issue is that of
those occasional bottles that almost everyone seems hell-bent on.  I always
figured giving the mothers a decent pump upped the odds that they would be
putting their own breastmilk in those bottles instead of the artificial
stuff that they get so many samples of from the docs.  Unless they come to
the breastfeeding class, what I find most moms have bought are those
good-for-nothing $40 electric breastpumps.  I like being able to offer them
a decent pump at no cost, and we explain why their small electric pump may
be ineffective and painful and encourage them to return it if they find
this to be the case.

So, is this all a waste of money and does it send the wrong message?  Or
might it increase the odds of babies getting breastmilk for a longer period
of time?
Becky Krumwiede, RN, IBCLC, Appleton, WI
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