Jeanette,
I just listened to a tape from a session at ILCA 95 by Sandra Lang(I think),
a midwife in England. The topic was mechanical versus hand expression. She
works with mothers of preemies and they have compared hand expression with
mechanical. Apparently the milk extracted by hand is different in composition
than that gotten mechanically. Mothers did not get as much volume expressing
by hand but were able to keep up with their babies needs. They tested the
milk for some components and found it higher in sodium for one. They
hypothesize that hand expressing is more like a baby, being a compression
method, than the electric pump which is a vacuum method. She went into great
detail about how to effectively hand express, including nipple stimulation,
massage and finding the lactiferrous sinuses when expressing. I find this
fascinating. I don't remember her addressing the need for fortifiers. Was
anybody at that session? Could hand expression be better for moms of preemies
and others for that matter? I can see a difficulty with American moms. We
want things to be fast and easy.
Marilee Woodworth, IBCLC, LLLL, Ann Arbor, Michigan
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