I agree that research should be done comparing hand expression vs. pumping
for the first 48-72 hrs.  We (www.cpqcc.org - infant nutrition toolkit)
recommend using hand expression as an adjunct to pumping. My only concern is that some
women will do it correctly, others not so well - will we be compromising
potentially good milk supply if a Mom does it incorrectly?  Some Moms also are
hesitant to touch their own breasts so aggressively, whereas pumping with a
mechanical device seems more culturally acceptable!

Nancy
Nancy E. Wight MD, IBCLC, FABM, FAAP
Neonatologist, Sharp Mary Birch Hospital for Women and Children's Hospital
Medical Director, Sharp HealthCare Lactation Services
San Diego, CA
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