On 12/09/2006, at 1:48, Nikki Lee wrote:

> Dear Friends:
>     Hand expressing is the most cost effective. Hand expressing  
> frees us from
> worry about availability. I wish every mother knew how to hand  
> express; she
> always has her hands with her and they are  silent.
>    Hand expressing would make the debate about pumping much  
> smaller. While
> pumps are easier for mothers that have to build a supply or sustain  
> a supply for
> a baby in need, they are not necessary.

Maybe not for all, but they are for some (possibly many, I've no way  
of knowing). Speaking for myself: I hand expressed quite a bit in  
emergencies, for baby food and so on, but I could never empty that  
way - I would get less than a third of what a hospital grade pump  
would get out (high quality manual and retail double electric pumps  
didn't fully empty me, either). After a single session of hand  
expressing more than a few ml, my MCP joints would hurt for days (I  
have hypermobile, damaged joints).

And in reality, in my life and my situation: if my hands had been  
occupied expressing those multiple times per day, I don't believe  
that I would have exclusively expressed for over a year. Sometimes  
"easier" really does make the impossible possible, for an individual.  
I couldn't (or wouldn't) have hand expressed while working, in  
meetings, in cafes, sitting in an aeroplane seat, while feeding and  
changing nappies, while chatting in the middle of extended family  
gatherings meals and so on - all places and situations I pumped  
(handsfree, and covered in company).

I think every mother should know hand expression, _especially_  
pumping mums (having ranted on this before!). I'm not convinced that  
every mother with a baby unable to breastfeed is able to build and  
maintain a good supply in the long term with hand expression alone. I  
think that pushing "pumps are unnecessary" in all times and for all  
women can fail to meet a mother where she is; and if that doesn't  
happen, you are left with no way of continuing the journey together.

Lara

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