Thank you for those responses. I'm glad to be armed with more evidence
supporting early hand expression!

I work in a hospital environment where most staff turn to the breast pump
at the first suggestion of breastfeeding difficulties. I regularly see moms
on the second day who have pumped every 3 hours for 24 hours or more
without removing *any* milk whatsoever, because no one coached them through
hand expression! (Can you guess whether their babies were supplemented with
artificial milk?) That is not ok, especially when the solution costs
nothing and is literally under our noses.  I'm doing what I can to
encourage a culture of hand expression, however, my hospital is not Baby
Friendly, and many nurses are not aware of what a difference it can make.
There is also the fear (even from some IBCLCs) that when mom practices hand
expression, she will not see any milk expressed. (There are many factors
influencing the flow of colostrum, as we know, but that is no reason to
skip teaching hand expression.)

Can any of you share ideas or lessons learned for encouraging staff to
promote hand expression? Thanks in advance.

Julie-Ann Toalston, IBCLC
Connecticut, USA

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