Jennifer, agreeing with Barbara, wrote about a mom she helped that

<< She was using an Evenflo pump and getting barely an ounce of milk (day 4,
I think). I
 told her to go to the store and exchange for an Avent before I came over.
 About 4 hours later, I saw her and she couldn't believe the difference. She
 was already pumping twice the milk and found it to be much more comfortable.
>>


All this is clearly true -- good pumps are a lot better than bad pumps.

On the other hand, last week I helped a one-breasted mother of twins,
supplementing heavily, who told me that pumping after every feed with her
Medela Lactina (which I consider a great pump, as pumps go, speaking as one
who has pumped over two years of my life so far!) she was getting only drops.
  I taught her **over the telephone**, to hand express, and half an hour
later she called me back, raving, "It SQUIRTED out!  My milk SQUIRTED out! I
never saw that before!"

So sometimes the answer is not a higher-tech pump -- sometimes it's, as
someone else wrote a while back, "the tools at the end of your arms."   And
that's especially true for people with pump-anxiety, which can be so
aggravated by the mechanical, dairy-farming kind of feeling of plugging in to
the device.  I think it's also a godsend in the middle of the night, when
it's quiet and doesn't require lights and outlets -- stuff that makes it
harder to go back to sleep when you are done.

Based on which, a related question.  When we saw that mothers whose babies
are NPO need to "pump 10 times a day" or whatever, in the first days, before
lactogenesis II, do we actually mean *pump*, like, with a device, because the
suction is important here?   Or is, say, Marmet technique of hand expression
an OK substitute for this kind of nipple stim ?   What are folks doing in
countries where sick babies' mothers don't have pumps available, and does it
work OK?  I can imagine that some of these mothers might want to use the
double pump at some hours, and their hands at night, or at their mother's
house, or whatever, if we all thought it was just as good (or better?).

Thanks for your opinions.

Elisheva

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