Dear Lara and others - 

As a LLL Leader, I can tell you that one of our most common meeting 
scenarios goes something like this: a pregnant woman attends for the first 
time, listens to my opening remarks, and then begins with this 
question: "What kind of pump do I need?".   Not "why should I breastfeed 
my baby?" or "how can I get breastfeeding off to a good start?" or any 
other question that is in fact universal to all mothers.  The perceieved 
notion in my area, and in Western culture as far as I can tell, is that 
ALL breastfeeding women need pumps, and they need the best one available 
regardless of their situation, and they must have it BEFORE the baby 
arrives.  I know this has been discussed before on Lactnet, but I feel it 
is so important to address, because I believe that advertising must play 
some role in this perceived need.  When women make a purchase at a 
maternity store, or a baby store, or open just about any magazine aimed at 
new parents, they are not just bombarded with ABM ads - they are also 
bombarded with ads from pump companies.  This "normalizes" expressing 
breastmilk for them, and makes it appear that, of course if you plan to 
breastfeed, then you must also have a pump and the associated gadgets.
When the above mom opens my support group meeting with the pump question, 
I am very careful to ask her a LOT of questions about her situation, why 
she feels she will need a pump, if she expects to be separated from her 
baby and at what age and for how long, etc.  Usually one of my wonderful, 
long-time group moms will speak up about how she never needed a pump, and 
another will chime in about the pump that she spent hundreds of dollars on 
but never used.  Of course I will supply this mom with pump and pumping 
info. when warranted, but only after I make sure she understands the 
basics of breastfeeding - and that a pump is generally not required, and 
easily accessible (in my area, at least) if it turns out that one is 
needed.  Of course pumps have their place - and there are few women in 
this world whom I admire more than those of you who have, for whatever 
reason, exclusively pumped to provide EBM for your babies!  But again - so 
many moms just don't need this technology getting in the way of direct 
breastfeeding.  And here's one more vote for hand expression: I do not 
know if it is a practical alternative for full-time expression, as I never 
used it for this reason, but some women are pretty quick and efficient at 
it - and for the mom who needs to express milk occasionally, it is an 
easy, cost-effective method for relieving engorgement, leaving a bit of 
EBM behind when mom is experiencing occasional separation from baby, etc.  
A personal story: the few times I prepared early solids for my second 
child and wanted to thin them out with my milk, I just leaned over the 
bowl and expressed some milk in.  My father-in-law, who lives next door 
and is prone to wandering around our adjoining properties and entering our 
house without knocking (that's another story!) peered in the window one 
day as I was making some oatmeal for the baby.  He backed away pretty 
quickly - and later asked my husband when we were going to get curtains on 
the windows!  Unfortunately, that episode did not cure him of his "peeping 
Tom" ways...

Karen Pogge, MD, LLLL, awaiting the birth of daughter #3 in eight weeks

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