Melissa Vickers:

Yes, you are correct that this study does have some limitations. All
Breastfeeding studies do. I mentioned this study for the following reasons:

1. Most of the posts on this subject were dealing with subjective information.
This study even with limitations, gives some objective data.

2. The study again dealt with the Product/Process information which I find
especially interesting. "why do mothers formula feed when they know Breastmilk
is better?" If this subject can be understood and a plan made significant impact
can be made on Breastfeeding rates. not from 55% to 60% why don't we shoot for
much higher goals like 95%. Also lets review the use of Breastfeeding resources
and see if they are appropriate being utilized? Will Billboards, Breastfests,
and other promotional meet this target when they are product versus process
oriented. How is your local task force utilizing its resources?

3. Many of the posts dealt with a person's personal vision of Breastfeeding. You
can read this into so of the posts:

        A) My vision is Just a Baby on the Breast without any intervention

        B) My vision is to have mothers exclusively BF as long as possible

        C) My vision is to have mothers BF with as many resources available, if
needed

Objective data helps somewhat. I don't think that any vision is right or wrong.
However, in dealing clinically with a mother, the mother needs to be assessed of
what her vision is and that leads to...

4.  A conclusion in the study that Pumps were especially helpful for mothers
that indicated that ease of nighttime feeding was important.


Meeting a mothers needs is important. Giving a pump to a mother that has
nighttime feeding concerns may be justified. Giving a pump to a mother that has
a vision of Breastfeeding without intervention may not be appropriate.

It may all be a moot point anyway. With managed care,  most hospitals now get a
set amount of money for each birth. Thus, the days of the $80 breastpump are
numbered.  Now the hospital actual pays for their pumps. The expense is often
not sent to the insurance company.  Despite the Managed care name there is no
managed care in many cases. The real purpose of this  process is to reduce
hospital and insurance company expenses and pumps (and lactation services)  are
often seen as a luxury. As one OB supervisor stated. I don't care what happens
outside the hospital. I just need to get expenses cut!!!!

Its also interesting to note that some ABM companies representatives outside the
USA  state that Breastpumps are prohibited under the WHO code. This is being
done  to discourage the hospital  from sending mothers home with a manual
breastpump in some third world countries.  Why would ABM companies do
this.........?

Richard Weston
Medela Inc.