I think that we all hope that pump companies market their products 
without equating them with feeding at the breast. However, I do not 
hesitate to recommend a suitable pump when i feel it is necessary to 
help initiate or preserve breastfeeding or being able to provide 
breastmilk for a baby. People are not obligated to use pumps in 
situations where they are unnecessary nor is anyone obligated to like 
pump companies. In the United States we have over a 12% rate of preterm 
birth, over a 30% cesarean rate and no national maternity leave policy. 
Pumps are a necessary part of breastfeeding in the US for many mothers, 
even if some contributors to Lactnet are unhappy with the notion of 
mechanical pumping. Many of our mothers do not have the luxury of 
staying home for 6 months or a year while collecting a paycheck. Most 
of our mothers cannot afford to take unpaid leave for more than a few 
weeks. In a study of approximately 2000 US mothers, 5.6% of those who 
breastfed were exclusively pumping.

Shealey et al. Characteristics of breastfeeding practices among US 
mothers. Pediatrics. 2008;122:S50-S5

Using the same sample as above from the Infant Feeding Practices Survey 
conducted by the CDC, another analysis of these breastfeeding mothers 
showed that the main reason for pumping was maternal employment. 
Remember that half of all mothers in the US with children under 1 year 
of age are employed and one third are employed full time.

Labiner-Wolfe et al. Prevalence of breast milk expression and 
associated factors. Pediatrics. 2008;122:S63-S68

Maybe we should cut these mothers a little slack. I too dislike any 
reference that equates pumping with feeding at the breast, but please 
remember that many of our mothers depend on pumping to preserve their 
milk supply. We don't need to encourage them to put pumps on their 
birth registry for baby showers but I don't think we should deprive 
them of a necessary tool because of a dislike for anything other than 
pure feeding at the breast.

Marsha Walker, RN, IBCLC
Weston, MA

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