Some of the concerns I have heard from IBCLCs about those mothers who are using pumps in addition to breastfeeding their babies is that the pumping will interfere with their breastfeeding (delaying a feeding after pumping, so the breast will "fill up"), provide them with false information about supply (I "only" pumped 3 ounces after breastfeeding), cause oversupply and more complications, etc....

This is a question for Katherine Dettwyler and those of you who have lived in areas of the world where breastfeeding is the primary, traditional, protected way to feed babies (does any place exist like that now? ...or do we need to look back many, many years?).

I have spoken to women who talked about THEIR mothers' breastfeeding in Central and South America, and Africa - one described walking to a neighbor's house to get the neighbor to give her a cup of expressed milk when her mom didn't have enough for the new baby, another talked about her aunt breastfeeding her and her brother at different times, another of cousins who took turns at the field and at staying with both their babies, etc.  

Perhaps, now, instead of cousin, neighbor or sister - we have pumps!  Of course the isolation and lack of support cannot be replaced with a machine, but the feeling of having a "backup" and being assured there is extra milk may be just the right thing for some moms.  

I met one working mom who always felt she HAD to have 30 ounces of milk in her freezer.  She would breastfeed and pump, and build it up, and then was able to relax.  

Of course there are moms  that never need to have these backups, and there are moms like me, who in 1971 hand expressed and had a couple of bottles in case of an "emergency".  The "emergency" never happened, and I finally threw it away well after my son would have needed it, which only demonstrates how rarely I emptied my freezer during those busy years.  

It seems that communicating with moms about pumping, just as with every other aspect of breastfeeding, needs to include a lot of questions about why they feel the need for it ("can you tell me more?"), a lot of information about the pros and cons and risks (oversupply, mastitis, etc.) - and then supporting mothers to do what they feel they need to do, realizing that their choices are not coming out of a book or research, but their own hearts and needs...and that there is no "right" answer for everyone...

Jeanette Panchula, BSW, RN, PHN, IBCLC
Vacaville, CA

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