I'd like to respond to Valerie's question of a mother insisting on a pump
when simply nursing more often would solve her problem.  Valerie compared
this to a mom insisting on an antibiotic for a viral infection.  I don't
believe this is a valid comparison because in that case the antibiotic would
do no good to help the situation and may actually cause harm.  The pump, on
the other hand, is simply another way to approach the same problem of
removing more milk more frequently.  It may not do it as effectivelly as the
baby and it certainly is more expensive, but it is the mother's choice of
what she feels would work best for her in her life at the moment.  I feel it
is not my place to judge this mother's decisions.  So I believe that I would
inform her that she doesn't need the pump to solve her problem and that
actually nursing more often would be the most effective, but if she insisted
on it I would rent a pump to her anyway as that is what she wants.  In fact,
I have often done this very thing of explaining that a pump is not the best
choice for whatever situation that particular mother is experiencing for
which she called to request a pump.  I think it's more like when a mother
calls to ask how to wean her baby. I first answer her question and then
gently ask why she's interested in weaning and discuss what other ways may
help her situation without weaning.  But by answering her question first,
she is able to hear the rest of the discussion.  If I refuse to rent a pump
to someone who insists she needs it, then I am not listening to the mom
where she is and I've lost any effectiveness I may have had to help her.
    Kristeen Rogers, RN, BSN, IBCLC

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