> Has anyone out there looked at the new Avent video featuring Dr. Lucas
> and claiming that the Isis is as effective as a hospital grade electric
> for moms of preemies?

And how did it compare to hand expressed milk?  Should this be part of a
protocol of good enough trialling, that any expressed milk should be
compared to hand expressed milk?

I recently went to a talk by Sandra Lang, whom some of you may know through
her book / work on breastfeeding premature babies and hand expression.  One
thing she showed us was some unpublished work of her own on the difference
in milk composition depending on whether it was expressed by hand or by
machine.  [The slide she put up was of sodium content, and showed the same
woman's milk during four weeks, when she hand expressed on weeks one and
three and expressed by machine in weeks two and four -- if my memory is
correct.  Machine expression created more milk extracted -- which might even
be too much for a prem baby -- but a very different micro-composition.]  I
asked her about Lucas's early studies on prem babies and the difference
receiving human milk made to subsequent intelligence (his 80's research) --
did Sandra know how the milk in those studies was collected?  She told us
that she had phoned Alan Lucas at some point to ask him this very question
and *he* did not know how the milk had been expressed.

Now, at that time, I do not feel Lucas should have been aware that the
method of expression might make a difference to the study.  However, it
shows that, while he was in charge of the research, he was not involved in
the hands-on implementation of it.  He is therefore, in my book, not
necessarily the person to ask to speak to the experiential aspects of
getting milk out of oneself.

I would also be interested to know what this film regards as measures of
'effectiveness' in regards to the different pumps.  Is it volume alone?  I
think we should be careful about using this as a sole measure, although, of
course, it is the one you can easily present to women.  Using volume as the
most important measure of effectiveness seems to me to push the
consideration of breastfeeding toward the 'product' end of the
'product-process' continuum which is used by Penny van Esterik in her work.
Do we agree with that?  I agree that there are considerations of getting
enough milk for the baby, but I saw, in my distant years as a pump agent, a
lot of damage done to breastfeeding and maternal confidence by the focus on
quantity.

Magda Sachs
Breastfeeding Supporter, BfN, UK

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