Karleen describes how she got less with hand expression after about a week. (And this is from a person certainly knowledgable and well motivated.) A couple factors come to my mind. The first, as she implied, may be the difference between single and simultaneous double removal. I believe a study did show higher prolactin levels with the double pumping. I suppose with the right setup, some very adept moms might be able to hand express both at the same time, but I think that would be logistically difficult for most. The factor that would be difficult to quantify is that of fatigue. Let's face it, it takes less effort to hold 2 flanges in place (a rather passive acitvity) than to be repeatedly flexing (with resistance) and extending the fingers. Is there an unconscious tendency to slow down or not compress as firmly or effectively after a while due to the hands getting tired? It might not even be something the mom is conscious of but could be a factor. Just speculating. Winnie *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html