Karleen asked why you use breast shields while pumping.  The shields (otherwise called flanges)
are the pieces that go on the breast while you are pumping.  I'm not sure how else you would get a
pump to function without placing something on the breast to create suction.

In response to her question about pump trauma.  The answer is yes, we do get a lot of trauma.
Ever since I started noticing it, I ALWAYS watch every single woman who we see who is using a
breast pump.  When I started doing this it was a huge revelation to me.  Often this is when the
reasons for not wanting to pump come out.  It is a time when I have found I can find a lot of little
things to make mom more comfortable until her supply is optimized or her baby is efficient
enough to either complete feedings on the breast or maintain the supply.  When mom is in an
iatrogenically induced low supply situation - or baby can't go to the breast because of a medical
condition (e.g. baby still in NICU) positioning for pumping is every bit as important as positioning
for breastfeeding.  Number one is getting mom comfortable.  I see the same hunched backs, oddly
bent wrists, and tense muscles with pumping that I do with breastfeeding.  I

Often mothers won't mention the discomfort of pumping when you ask the first time.  They think
it is like breastfeeding, sort of a hairshirt like torture that you're supposed to endure for your child
until you get your supply up (or in the case of breastfeeding until your nipples toughen up).  In
both cases, there is often an "aha" moment, you mean this is the way breastfeeding/pumping is
supposed to feel?  I hate the martyr attitude that has been adopted by our bottlefeeding culture
towards breastfeeding.  If more women knew that they were deprived of years and years of innate
learning and observation of breastfeeding they wouldn't think pain was normal.  Fewer of them
would need our help and fewer of them would have to resort to what I have started to call our
modern day equivalent of the wetnurse (the pump).  I so wish we could start working on the
physiologic low supply and figure that out, rather than having to correct all sorts of iatrogenically
induced low supply problems.

Susan E. Burger, MHS, PhD, IBCLC

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