I agree with all your points Barbara. Even with this approach though I find very poor outcomes with the community I work with - these are mothers who all expected to breastfeed because that is part of their culture, but who find it incredibly difficult for a multitude of reasons to pump to establish their milk supply if anything happens to get in the way of breastfeeding getting off to a good start. I would love to find something that would give more success! 
Having said that, women who have breastfed previous babies invariably do well. I know this is partly because getting things going is easier second time around, but not only - they pump frequently, whatever it takes. My first time mums just don't pump more than 3- 4 times a day, no matter what I say to help make it do-able, or to impress how important it is, and no matter how much they want breastfeeding to work. 

Sally Etheridge IBCLC

 		 	   		  
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